On June 17, the FDA announced that it had approved a new drug for the treatment of pediatric Type 2 diabetes:
“The U.S. Food and Drug Administration today approved Victoza (liraglutide) injection for treatment of pediatric patients 10 years or older with type 2 diabetes. Victoza is the first non-insulin drug approved to treat type 2 diabetes in pediatric patients since metformin was approved for pediatric use in 2000.”
The approval comes on the heels of an article in the New England Journal of Medicine which pitted 66 liraglutide recipients against a control group. In the Novo Nordisk funded study, the results were resounding: those receiving the treatment, which is already commonly used by adults, saw their A1C drop by .64 percentage points a year later. The adolescents receiving the placebo saw their A1C actually increaseby .42.
At ASweetLife.org, often we find news like this bittersweet. It’s certainly good that a new tool is available for diabetes management,and many children may benefit by adding this medication in concert with metformin, and may experience improved glucose control with a concomitant decrease in the risk of diabetic complications. Children with T2D are at a scarily increased risk of macrovascular complications, and they are overrepresented among minority communities that may have lesser access to fresh food, and less time or money to pursue lifestyle changes. Children with Type 2 diabetes need all the help they can get. At the same time, it is continually frustrating to see that pharmacological solutions are often the preferred treatment for a lifestyle disease.
Experts agree that obesity is “the most powerful determinant of Type 2 diabetes in childhood, adolescence and young adulthood.” The disease was virtually unheard of in children only generations ago, but it has been on an unabated rise in the past several decades, enough to the point where it is routinely described as an “epidemic.” The overwhelming majority of children with T2D are overweight; little physical activity and poor dietary choices are the norm.
While all agree that diet and exercise ought to be the keys to managing Type 2 diabetes in children, there also appears to be something of a consensus that these natural and obvious solutions are generally doomed to failure. An academic review of treatment options, noting the distressingly low rates of adherence to lifestyle interventions, observed that it is possible “that patients do not understand the importance of diet, as it is not a medication being prescribed.”