The only drug approved thus far for type 2 diabetes in children is metformin, but at least one group of doctors believes there could be a second option: glimepiride (Amaryl), a potent sulfonylurea.

The doctors are investigators who compared the two agents in 263 children (aged 8-17) at several sites in the United States and Germany. All the youngsters had failed to respond to previous oral antihyperglycemic therapy combined with diet and exercise. Their hemoglobin A1c levels ranged from 7.1% to 11.9%.

After 24 weeks, the metformin group showed a drop in A1c of 0.85 percentage points compared with a drop of 0.69 percentage points in the glimepiride group—a significant decline in both groups, according to the investigators. Side effects occurred at similar rates, except the glimepiride children gained slightly more weight (4.3 lb) than the metformin group(1.2 lb). The number of hypoglycemic episodes in each group was similar, but the researchers acknowledged that the glimepiride dosages were relatively low (3.8 mg/day).

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The researchers say the findings “indicate glimepiride is safe and effective for use in the pediatric population and provide a needed addition” to therapeutic options (Diabetes Care. 2007; 30:790-794).