What Is Best for Young Type 2 Patients?

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This was to have been part of my Fridaytidbits, but this is getting fever pitched publicity so I ampublishing this.
A youth study of type 2 diabetespatients to determine optimal potential glycemic control seems tohave determined that a drug pulled from the market for adult type 2patients is the drug of choice for our youth. The ages of peopleeligible for the study included youth from age of 10 to 17. In lightof Avandia being pulled from the market, I have to wonder at thevalue of the study. Or, is this another attempt to bring it back onthe market for the youth with type 2 diabetes. I can only hope thiswill not happen.
Realizing that the ages selected forthe study is the age when our youth are trying to spread their ownwings, find their own place in this world, and rightfully the mostrebellious about authority, it is not surprising that overall failurerate is above 50 percent. I can also understand the need toestablish evidence for clinical application in the treatment of youngpatients with type 2 diabetes.
The study was funded by the NationalInstitutes of Health. Three groups were analyzed, one on metforminand Avandia, one on metformin only and one with metformin andintensive lifestyle intervention. None (that is right – none) ofthe groups did that striking well to clearly say one was better byfar than the others. The two-drug regimen did do enough to bedeclared the better treatment option.
Some youth did lose weight at thestart, but most did not and the majority actually gained some weightover the study period. Not a stellar performance by any standard. Read the results posted by NIH, and twoarticles in the New England Journal of Medicine here and here.
I am wondering, aloud or in writing ifyou prefer, why we expect our youth to lose weight on the informationon food put out by the USDA and advocated by the American DiabetesAssociation, the Academy of Nutrition and Dietetics, the AmericanAssociation of Clinical Endocrinologists, and the AmericanAssociation of Diabetes Educators. Even a few nutritionists followthis, but more are finding it more important to actually teachnutrition and keep the preferred diet of many with diabetesnutritionally balanced rather than loaded with carbohydrates.
I also wonder why doctors prefermedications over any other form of treatment, when it is obvious thatour youth needs to reduce their carbohydrates and whole grainconsumption. Input some physical activity, less cell phone use, andless time spent sitting, and our youth may realize some real weightloss. There is some excellent discussion about this here. I am nota member so I can only read, but the discussion is good and someexcellent points were raised.
Do keep your eyes open, this is makingthe rounds in the different medical circles and publications. Readthe article in WebMD for a slightly different perspective. I suspectthe newspapers will be featuring it also.