[Treatment of adolescents with type 2 diabetes].
BACKGROUND
A worldwide increased incidence of adolescents with type 2 diabetes mellitus is evident. Only few substances are available for treatment of adolescents with type 2 diabetes. We report on our experience of treatment in the diabetes centre in Leipzig, Germany.


METHODS
At the moment we care for three patients with type 2 diabetes (two girls and one boy) age 16 - 17 years. We retrospectively analyzed the patients records for symptoms at onset, BMI, HbA1c and treatment for a maximum of 4 years.


RESULTS
None of the adolescents had typical symptoms at onset. All had first or second degree relatives with type 2 diabetes. Diagnosis was made using oral glucose tolerance test. BMI at onset was 26 kg/m (2) (90.-97 percent) to 35.2 kg/m (2) (>99.5 percent). Fasting and stimulated insulin and c-peptide levels were elevated in all cases. An elevated HbA1c level was found in one patient. Two patients had further metabolic symptoms like hypertriglyceridemia or hyperurikemia. We started with metformin after dietary instructions in all cases. One girl is on insulin at the moment and the boy stopped metformin after weight reduction of 24.5 kg.


CONCLUSIONS
In Germany type 2 diabetes is diagnosed more frequently at an early age. Adolescents with type 2 diabetes should be treated in a centre for pediatric diabetology. Treatment should consist of an individualized care for all aspects of type 2 diabetes.
Kapellen
T M
TM
Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig. kapt@medizin.uni-leipzig.de
Böttner
A
A
Galler
A
A
Raile
K
K
Nietzschmann
U
U
Kiess
W
W
D000293:Adolescent; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D003927:Diet, Diabetic; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*
D002096:C-Peptide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin