Study finds that more children are using drugs that treat Type 2 diabetes

ST. LOUIS -- The number of children ages 5 to 19 taking prescription drugs used to treat or prevent Type 2 diabetes has doubled in the past four years, according to a study released Wednesday by one of the nation's largest pharmacy management companies.

St. Louis-based Express Scripts Inc. reviewed records for 2002 through 2005 for children enrolled through the company's commercial health plans. The study involved at least 3.7 million U.S. children each of the four years.

Diabetes occurs when the body can't turn blood sugar, or glucose, into energy, either because it doesn't produce enough insulin or doesn't use it correctly.

With Type 1 diabetes, the patient's own immune system attacks the insulin-producing islet cells in the pancreas. Insulin, given by shots or a pump, is required to survive.

With Type 2 diabetes, the body is unable to use insulin efficiently, even though the pancreas pumps out extra, and drugs often are given to increase production further. Type 2 often is associated with being overweight.

Both forms can lead to heart and kidney disease, blindness and amputations, and death if not properly treated. The American Diabetes Association said 1.5 million people in the U.S. are diagnosed with diabetes each year.

Dr. Lori Laffel, chief of pediatrics at the Joslin Diabetes Center, which is affiliated with Harvard University, said many more diabetic children have the Type 1 form. But the number of Type 2 cases is on the rise.

"There is no question that has increased significantly," Laffel said. "With being overweight comes inactivity, and those are two potential risk factors for developing Type 2 diabetes."

Express Scripts performed the study as part of an effort to understand the reasons for rising health care expenses, said Emily Cox, the company's senior research director and the study's lead author.

Type 1 patients were identified as those taking mono-therapy insulin or insulin with newer adjunctive medications. Type 2 patients were identified as those taking an oral antidiabetic agent alone or in combination with insulin or the adjunctive therapy.

The study showed a significant rise in children using Type 1 medications, too -- 31 percent over the four years. For children taking medications to treat or prevent Type 2, the increase was 104 percent.

Laffel noted that the increase in prescriptions could be due in part to doctors being more confident the drugs are safe.

Ed Weisbart, Express Scripts' chief medical officer, said Type 2 diabetes was previously known as "adult-onset diabetes" because it struck mostly adults who were middle-aged or older.

"Very clearly, the increase in diabetes prevalence among children signals the beginning of multiple health care issues for many, many children as they grow into adulthood, and vast economic costs to our society," Weisbart said.