medwireNews: The RISE investigators have reported a continued lack of effect of early intensive therapy on beta-cell function decline in children with prediabetes or early type 2 diabetes.
The latest data, reported by Kristen Nadeau (University of Colorado Anschutz Medical Campus, Aurora, USA) at the 54th EASD Annual Meeting in Berlin, Germany, extend to 21 months of follow-up.
The researchers previously reported data for 12 months of follow-up. The new findings involve 75 patients, aged 10–19 years, who underwent an oral glucose tolerance test at 21 months and had not required additional medications beyond metformin during this time. But during this period beta-cell function deteriorated further, irrespective of treatment.
Nadeau noted this contrasts with findings in adults, in whom intensive treatment appears to slow the decline in beta-cell function. The decline seen in the children in RISE also occurred when the analysis was restricted to those who had prediabetes at baseline, rather than type 2 diabetes.
Previous analyses had seen a significantly higher BMI among patients randomly assigned to receive glargine followed by metformin relative to the metformin-only group during the first few months of treatment, and this persisted at 21 months, but the significant decrease in glycated hemoglobin was lost.
Nadeau highlighted the need for further research to understand the mechanisms underlying the rapid beta-cell decline in youth with type 2 diabetes, but also emphasized the importance of finding effective ways to prevent and treat obesity.
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