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Published Online, 8 August 2006, www.theannals.com, DOI 10.1345/aph.1H130.
 The Annals of Pharmacotherapy: Vol. 40, No. 9, pp. 1517-1521. DOI 10.1345/aph.1H130
© 2006 Harvey Whitney Books Company.
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DIABETES

Prevalence and Treatment of Metabolic Syndrome in Adolescents with Type 2 Diabetes

Brittany Harris Sanders, PharmD

at time of writing, PharmD Student, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AK; now, Assistant Store Manager, Walgreens, Little Rock

Lisa M Lubsch, PharmD AE-C

Assistant Professor, Department of Pharmacy Practice, School of Pharmacy, Southern Illinois University Edwardsville, Edwardsville, IL

Donna S West, BS Pharm PhD

Assistant Professor, Division of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences

Reprints: Dr. Lubsch, Department of Pharmacy Practice, School of Pharmacy, Southern Illinois University Edwardsville, Edwardsville, IL 62026-2000, fax 618/650-5163, llubsch{at}siue.edu

BACKGROUND: The incidence of obesity and type 2 diabetes among adolescents has risen dramatically in recent years, and it is likely that many of these adolescents also have metabolic syndrome.

OBJECTIVE: To investigate the prevalence of metabolic syndrome in the patient population enrolled in a children's hospital type 2 diabetes clinic and to describe baseline pharmacologic treatment and adherence patterns.

METHODS: In this retrospective cohort study, the medical charts of 52 adolescents were reviewed. A data collection instrument was used to collect demographic data, laboratory values, medication lists, and documented adherence patterns from the patient's initial clinic visit. Data collected were used to identify patients with metabolic syndrome. Data were entered into a database and analyzed using SPSS 13.0.

RESULTS: Data were collected for 52 patients; of these, 40 (76.9%) had characteristics of metabolic syndrome meeting 3 or more of the 5 criteria, although only 8 (15.4%) were diagnosed with the metabolic syndrome. Among patients with characteristics of metabolic syndrome, 92.5% were taking a glucose-lowering drug, with 85% of those receiving metformin. Sixteen (40%) patients were receiving a blood pressure-lowering medication at baseline, and 4 (10%) were taking a lipid-lowering agent. Forty-three percent of these patients reported nonadherence to their prescribed drugs.

CONCLUSIONS: Given these treatment patterns, pharmacologic management of metabolic syndrome in adolescents with type 2 diabetes may be suboptimal and may impact cardiovascular outcomes. It is important for clinicians to be aware of the incidence of type 2 diabetes and metabolic syndrome in adolescents so that treatment with lifestyle modifications and pharmacologic therapy may be implemented earlier.

Key Words: adherence, adolescents, diabetes, metabolic syndrome

Published Online, August 8, 2006. www.theannals.com, DOI 10.1345/aph.1H130




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