Advancements in pharmacotherapy options for treating diabetes ‎in children and adolescents

ABSTRACT

Introduction

This study compares diabetes management between pediatric and adult patients and identifies treatment challenges and gaps.

Areas covered

We searched PubMed and Clinicaltrails.gov databases for studies published from 2001 to 2023 on diabetes management in different age groups.

Expert opinion

Research shows children have lower insulin sensitivity, clearance, and β cell function than adults. The US FDA only allows insulin, metformin, and liraglutide as antidiabetic medication options for children. However, some off-label drugs, like meglitinides, sulfonylureas, and alogliptin, have demonstrated positive results in treating certain types of diabetes caused by gene mutations. It’s crucial to adopt personalized and precise approaches to managing diabetes in pediatrics, which vary from those used for adult patients. New studies support the classification of type 2 diabetes into several subtypes based on age, BMI, glycemia, homeostasis model estimates, varying insulin resistance, ‎different rates of complications‎, and islet ‎autoantibodies. With this insight, prevention, treatment, and precision medicine of diabetes might be changed. More research is necessary to assess the safety and efficacy of different antidiabetic drugs and improve diabetes treatment for children and adolescents.

KEYWORDS:

• Diabetes
• pharmacological
• children
• pediatric
• guideline

Article highlights

• When managing diabetes in children, it’s essential to use methods specific to their needs.

• The US FDA has approved only three antidiabetic agents – insulin, metformin, and liraglutide – for use in children.

• However, off-label medications like meglitinides, sulfonylureas, and alogliptin may be helpful for certain types of diabetes caused by gene mutations.

• Treatment is now personalized based on a patient’s weight and other factors, ensuring it is effective and safe.

• Managing diabetes in children requires balancing glucose levels with growth and development.

• Several subtypes of type 2 diabetes have been presented based on factors such as age, BMI, glycemia, insulin resistance, complication rates, and islet autoantibodies. ‎

• Achieving optimal outcomes necessitates regular monitoring, education, and close collaboration.

• It’s essential to incorporate physical activity and manage weight to effectively manage diabetes and positively impact blood sugar levels and overall health.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was not supported by any funding.