Type 2 diabetes in children and adolescents in a 2-year follow-up: insufficient adherence to diabetes centers

Horm Res. 2008;69(2):107-13. doi: 10.1159/000111814. Epub 2007 Dec 5.

Abstract

Background/aims: To study the 2-year course of children and adolescents with type 2 diabetes mellitus (T2DM) in general practice to present (1) the treatment modalities, (2) patient adherence, and (3) the occurrence of comorbidities.

Methods: HBA1c, lipids, blood pressure, treatment modalities, occurrence of retinopathy and nephropathy were analyzed in 129 children and adolescents with T2DM (median age 13.4 years, 75% female) in specialized diabetes centers in Germany.

Results: Seventy-eight (60%) children dropped out of care after a mean of 7.1 months. Drug treatment was not stopped in any of the 64 children initially treated with antidiabetic drugs. Sixteen (12%) children were treated solely by lifestyle intervention over the 2-year course. In the 51 children with complete follow-up, median HbA1c was 7.7% at diagnosis and 6.3% after 2 years. Less than 5% of all children were treated with antihypertensive or lipid-lowering drugs, while 65% suffered from hypertension and 44% from dyslipidemia. Over the course of the disease, retinopathy was not observed, while microalbuminuria occurred in 25%.

Conclusions: In general practice, many children and adolescents with T2DM were lost of follow-up. Lifestyle intervention as sole treatment was not often useful for long-term metabolic control. Dyslipidemia and hypertension were seldom treated as recommended.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Blood Pressure / physiology
  • Body Weight
  • Child
  • Comorbidity
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / therapy*
  • Family Practice
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / metabolism
  • Health Facilities*
  • Humans
  • Lipids / blood
  • Male
  • Obesity / epidemiology
  • Prospective Studies
  • Treatment Refusal*

Substances

  • Glycated Hemoglobin A
  • Lipids
  • hemoglobin A1c protein, human