Treatment Does Little to Prevent Hypertension and Microalbuminuria in Children with Diabetes

Children with type 2 diabetes continue to develop hypertension and microalbuminuria at fast rates, regardless of treatment, according to the results of a study published in the June 2013 issue of Diabetes Care.

The study included nearly 700 overweight children from the TODAY clinical trial, an ongoing study on treatment of type 2 diabetes in children and adolescents. Children in the current study were aged between 10 and 17 and had been diagnosed with diabetes for less than 2 years. The participating children were randomly assigned to receive metformin, metformin plus rosiglitazone, or metformin plus lifestyle intervention.

At the start of the study, 11.6% of participants had hypertension. By the end of the study (average follow-up of 3.9 years), 33.8% had hypertension. In addition, the rate of microalbuminuria among participants increased from 6.3% at baseline to 16.6% at the end of the study. The researchers also observed that boys and those with higher BMIs were at significantly increased risk for hypertension. Risk of microalbuminuria was associated with poor glycemic control, but not with a particular gender or ethnicity.

The authors note that the progression of hypertension and microalbuminuria observed in children was faster than that typically seen in adults and stress the importance of obesity prevention starting at young ages.