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A study conducted at Children’s Hospital of Pittsburgh of UPMC shows that early and aggressive medication treatment did not preserve the body’s ability to make insulin in high-risk obese youth with type 2 diabetes.
The findings were published online today in Diabetes Care and the results will be presented this week at the American Diabetes Association Scientific Sessions in Orlando, Florida.
The study included 91 youth partcipants ages 10 to 19, part of the larger Restoring Insulin Secretion (RISE) study. To determine if early, aggressive treatment would improve outcomes, participants at four study sites were randomly assigned to one of two treatment groups.
The first group received three months of glargine—a long-acting insulin—followed by nine months of metformin. The second group received only metformin for 12 months. Participants were then monitored for three more months after treatment ended.
The RISE pediatric medication study found that beta cell function—key to the body’s ability to make and release insulin—declined in both groups during treatment and worsened after treatment ended.
“I am not entirely surprised with the outcome of RISE not only because the disease appears to be more severe in youth, but because its pathogenetic mechanisms also are worse even in the stage of prediabetes,” said Silva Arslanian MD, pediatric endocrinologist and diabetologist, scientific director, Center for Pediatric Research in Obesity and Metabolism, and principal investigator of RISE.
Children’s Hospital was one of four sites that conducted the RISE pediatric medication study; the others were Children’s Hospital Colorado, Indiana Universtiy and Yale University.
National Institutes of Health support for RISE comes primarily through National Institute of Diabetes and Digestive and Kidney Diseases grants U01DK94430, U01DK94431, U01DK94406, U01DK94438 and U01DK094467, with additional support from the National Center for Advancing Translational Sciences.
The Department of Veterans Affairs, Kaiser Permanente Southern California, and the American Diabetes Association also support the studies, with additional donations of supplies from Allergan Corporation, Apollo Endosurgery, Abbott Laboratories, and Novo Nordisk A/S.