It is over 17 years since the randomised controlled trial of metformin showed efficacy in childhood type 2 diabetes. Since that time, despite much investment in paediatric investigation plans, very few interventional clinical trials have reported. This presentation reviews the evidence for childhood type 2 diabetes being different to adult type 2 diabetes. Childhood type 2 diabetes is a more aggressive disease; children have lower insulin sensitivity than adults; and complications occur earlier in the disease process. This presentation then reviews the results from the TODAY study, and the newly published results from the randomised controlled trial of GLP1-receptor agonist. While the natural history of the disease is that almost 50% of children will progress to HbA1c more than 8.5% on metformin, rosiglitazone, or lifestyle treatment, the recent study of Liraglutide (GLP-1 receptor agonist) in combination with metformin shows an improvement of over 1% in HbA1c compared with metformin alone. The presentation then reviews ongoing randomised controlled trials in childhood type 2 and the prospects for new classes of treatments becoming available.
27 - 29 Nov 2019
British Society for Paediatric Endocrinology and Diabetes