The Utility of Oral Diabetes Medications in Type 2 Diabetes of the Young

Background: An estimated two-thirds of medications prescribed for use in pediatric patients have not been proven safe or effective for this patient population. Since 1995 a dozen orally administered diabetes medications or combination of medications for the management of type 2 diabetes mellitus have been approved by the Food and Drug Administration. Of these, only one (metformin) is approved for use in pediatrics. As the prevalence of children diagnosed with type 2 diabetes continues to rise, the need for adequate information regarding the safety, efficacy, and appropriate dosing of oral diabetes medications in the pediatric population likewise increases. Objective: The purpose of this paper is to present the data available regarding the use of oral diabetes medications in a pediatric type 2 diabetes population. Methods: A computerized literature search was performed using Medline and the Cochrane Database of Systematic Reviews. Results: The Table consists of a summary of data regarding the use of oral antidiabetic agents in pediatric patients. These data include information regarding drug safety and efficacy and/or drug pharmacokinetic and drug dosing information. Conclusions: Data concerning the safety and efficacy of oral diabetes medications to treat type 2 diabetes of the young is limited. Data currently available support the use of metformin as first-line drug therapy. Results of prospective studies over the next three to five years will better define the role of thiazolidinedione use as initial therapy in pediatric type 2 diabetes patients.