Type 2 diabetes in children and adolescents in a 2-year follow-up: insufficient adherence to diabetes centers.
OBJECTIVE
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.
Reinehr
Thomas
T
Vestische Hospital for Children and Adolescents, University of Witten/Herdecke, Datteln, Germany. T.Reinehr@kinderklinik-datteln.de
Schober
Edith
E
Roth
Christian L
CL
Wiegand
Susanna
S
Holl
Reinhard
R
D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D001835:Body Weight; D002648:Child; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006268:Health Facilities; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D009765:Obesity / Q000453:epidemiology; D011446:Prospective Studies; D016312:Treatment Refusal
D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human