Efficacy and safety of hypoglycemic drugs in children with type 2 diabetes mellitus

Study Objectives. To assess the characteristics of children with type 2 diabetes mellitus and to determine the efficacy and safety of drug therapies for this disease in this population. Design. Retrospective review of medical records. Setting. Endocrinology specialty clinic at a tertiary teaching children's hospital. Patients. Forty-two children and adolescents with type 2 diabetes examined between January 1996 and December 2001. Measurements and Main Results. Demographic information, presenting signs and symptoms, drug history, and laboratory values were obtained in all patients. Presenting signs and symptoms were similar to those seen in adults. Patients were initially treated with metformin (14.3%), sulfonylureas (14.3%), insulin (31.0%), or combination therapy (14.3%). Most drug regimens decreased hemoglobin A(1c) (A1C) levels. Overall, patients treated with drugs had a significant decrease in A1C values, from 10.6% +/- 2.7% (mean +/- SD) before treatment to 8.0% +/- 2.0% at 3.2-52.9 months of treatment (p < 0.001). Adverse reactions attributed to drugs included hypoglycemia and gastrointestinal distress. Conclusion. Drug therapy appears to be effective in lowering A1C values in pediatric patients, although further prospective trials are necessary to determine optimal drug therapy in this population.