Type 2 diabetes in children

Overview 
Theory 
Diagnosis 
Management 
Follow up 
Resources 

Semaglutide

An alternative glucagon-like peptide-1 (GLP-1) receptor agonist that is approved for use in type 2 diabetes (T2DM) in adults, but not children. However, semaglutide is approved for the management of obesity in children ages ≥12 years with a BMI in the 95th percentile or higher for their age and sex. The brands of semaglutide approved for use in type 2 diabetes and obesity are different, and the doses used are also different.

Endoscopic bariatric procedures

Stand-alone, primary endoscopic bariatric procedures (e.g., intragastric balloons) for the management of obesity and certain obesity-associated comorbidities like T2DM, have evolved in recent years, bridging the gap between intensive lifestyle modifications and invasive bariatric surgical procedures.[93] In general, endoscopic bariatric procedures appear to be slightly less efficacious than bariatric surgery, although they are potentially slightly safer, less-invasive, and more reversible.[93]

Thiazolidinediones

Τhiаzοliԁiոеԁiοոеѕ, such as pioglitazone, increase iոsulin sensitivity and may also improve inѕulin secretion by preserving pancreatic beta cell function. However, these agents are not first-line choices for any age group due to adverse effects (including weight gain, fluid retention, heart failure, and decreased bone density). Pioglitazone is not currently approved for use in children.

Dipeptidyl peptidase 4 (DPP-4) inhibitors

DPP-4 inhibitors (e.g., sitagliptin, linagliptin) prolong the action of endogenous GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), resulting in a glucose-appropriate increase in insulin secretion and suppression of glucagon release. They do not have significant effects on body weight and do not cause hypoglycemia. Clinical trials of sitagliptin suggest that it has little or no benefit on glycemic control for adolescents with Т2DΜ, either as initial oral therapy or as an adjunct to treatment with metformin.[98][99] Similarly, trials of saxagliptin and linagliptin in adolescents found no significant improvement in hemoglobin A1c compared with placebo.[88][90] There is one ongoing phase 3 study to evaluate the efficacy of alogliptin versus placebo in children with Т2DМ.[100] DPP-4 inhibitors are not currently approved for use in children.

Use of this content is subject to our disclaimer