Maria J. Redondo, MD, PhD, MPH

Type 2 diabetes (T2D) is associated with obesity and is increasing at an alarming rate in youth. Pediatric T2D disease progresses more rapidly than adult T2D and is harder to treat. 

Dr Maria Redondo, a pediatric endocrinologist at Baylor College of Medicine in Houston, Texas, explains that insulin resistance is the major trigger of T2D, and beta-cell dysfunction is key to its development. In children, beta-cell dysfunction occurs more rapidly compared with adults. Children also have higher rates of complications and associated conditions, such as renal disease, cardiovascular disease, and nonalcoholic fatty liver disease. 

Dr Redondo references evidence from the TODAY study, which indicates that treatment failure with first-line metformin is common in the pediatric population and affords minimal weight loss.  

She then discusses GLP-1 receptor agonists as second-line therapy for children aged 10 years or older. There are currently two FDA-approved options: once-daily liraglutide and once-weekly exenatide. Both are given subcutaneously. 

Finally, Dr Redondo highlights DPP-4 inhibitors, such as linagliptin, saxagliptin, and sitagliptin, as well as SGLT-2 inhibitors, such as dapagliflozin and canagliflozin, as emerging therapies currently in clinical trials.  

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Maria J. Redondo, MD, PhD, MPH, Professor, Department of Pediatrics, Baylor College of Medicine; Staff Physician, Texas Children's Hospital, Houston, Texas 

Maria J. Redondo, MD, PhD, MPH, has disclosed the following relevant financial relationships: 

Received research grant from: NIH; NIDDK 

Type 2 diabetes (T2D) is associated with obesity and is increasing at an alarming rate in youth. Pediatric T2D disease progresses more rapidly than adult T2D and is harder to treat. 

Dr Maria Redondo, a pediatric endocrinologist at Baylor College of Medicine in Houston, Texas, explains that insulin resistance is the major trigger of T2D, and beta-cell dysfunction is key to its development. In children, beta-cell dysfunction occurs more rapidly compared with adults. Children also have higher rates of complications and associated conditions, such as renal disease, cardiovascular disease, and nonalcoholic fatty liver disease. 

Dr Redondo references evidence from the TODAY study, which indicates that treatment failure with first-line metformin is common in the pediatric population and affords minimal weight loss.  

She then discusses GLP-1 receptor agonists as second-line therapy for children aged 10 years or older. There are currently two FDA-approved options: once-daily liraglutide and once-weekly exenatide. Both are given subcutaneously. 

Finally, Dr Redondo highlights DPP-4 inhibitors, such as linagliptin, saxagliptin, and sitagliptin, as well as SGLT-2 inhibitors, such as dapagliflozin and canagliflozin, as emerging therapies currently in clinical trials.  

--

Maria J. Redondo, MD, PhD, MPH, Professor, Department of Pediatrics, Baylor College of Medicine; Staff Physician, Texas Children's Hospital, Houston, Texas 

Maria J. Redondo, MD, PhD, MPH, has disclosed the following relevant financial relationships: 

Received research grant from: NIH; NIDDK 

Type 2 diabetes (T2D) is associated with obesity and is increasing at an alarming rate in youth. Pediatric T2D disease progresses more rapidly than adult T2D and is harder to treat. 

Dr Maria Redondo, a pediatric endocrinologist at Baylor College of Medicine in Houston, Texas, explains that insulin resistance is the major trigger of T2D, and beta-cell dysfunction is key to its development. In children, beta-cell dysfunction occurs more rapidly compared with adults. Children also have higher rates of complications and associated conditions, such as renal disease, cardiovascular disease, and nonalcoholic fatty liver disease. 

Dr Redondo references evidence from the TODAY study, which indicates that treatment failure with first-line metformin is common in the pediatric population and affords minimal weight loss.  

She then discusses GLP-1 receptor agonists as second-line therapy for children aged 10 years or older. There are currently two FDA-approved options: once-daily liraglutide and once-weekly exenatide. Both are given subcutaneously. 

Finally, Dr Redondo highlights DPP-4 inhibitors, such as linagliptin, saxagliptin, and sitagliptin, as well as SGLT-2 inhibitors, such as dapagliflozin and canagliflozin, as emerging therapies currently in clinical trials.  

--

Maria J. Redondo, MD, PhD, MPH, Professor, Department of Pediatrics, Baylor College of Medicine; Staff Physician, Texas Children's Hospital, Houston, Texas 

Maria J. Redondo, MD, PhD, MPH, has disclosed the following relevant financial relationships: 

Received research grant from: NIH; NIDDK