Changes in diabetes medication regimens and glycemic control in adolescents and young adults with youth-onset type 2 diabetes: The SEARCH for diabetes in youth study
Year: 2018
Type: article
Abstract: Objective The aim of this study was to describe recent medication patterns and changes in medication patterns and glycemic control in adolescents and young adults with incident type 2 diabetes (T2D). Methods Using data from the SEARCH for Diabetes in Youth Study, we conducted a cross-sectional analysis of treatments for adolescents and young adults with incident T2D in 2 periods (2002-2005 vs 2008/2012), and a longitudinal analysis of medications and glycemic control for a subset with baseline and follow-up visits. Comparisons were performed using χ2, Fisher's exact, or ANOVA. Results Of 646 individuals in the cross-sectional analysis, a majority in each period received metformin (64.9% vs 70.4%) and/or insulin (38.1% vs 38.4%), while fewer used sulfonylureas (5.6% vs 3.6%) with non-significant changes over time. There was a significant reduction in thiazolidinedione use (5.0% vs 2.0%, P < .05). In the longitudinal analysis, 322 participants were followed for 7 years, on average. Baseline metformin users had a lower A1C (6.4% [46.7 mmol/mol]) compared to insulin (8.4% [68.2 mmol/mol], P < .001) or insulin plus any oral diabetes medication (ODM) users (7.7% [60.4 mmol/mol], P < .001). Among baseline metformin users (n = 138), 29.7% reported metformin at follow-up, with the remainder adding (19.6%) or switching to insulin (8.0%), ODM (15.9%), or lifestyle only (26.8%). Of those receiving insulin (±ODM) (n = 129), 76% reported insulin use at follow-up. Overall, 35% were at A1C goal (<7.0%, 53 mmol/mol) at follow-up. Conclusions Youth-onset T2D is still largely being treated with metformin and/or insulin. The majority treated were not at American Diabetes Association (ADA)-recommended goal 7 years after diagnosis.
Source: Pediatric Diabetes
DOI: 10.1111/pedi.12691
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1061576540, G1092462818, UCHSC Diabetes and Endocrinology Research Center, Colorado Clinical and Translational Science Institute (UL1), G2091809135, G22646245, G2320993242, G2698360221, G3146357332, G3437629819, Institute of Translational Health Sciences, South Carolina Clinical & Translational Research Institute (SCTR), Limited Competition for the Continuation of the SEARCH for Diabetes in Youth Cohort Study (UC4)SEARCH for Diabetes in Youth Cohort Study, G486112768, G4976965329, Center for Clinical and Translational Science and Training, G8090112403, G832786732, Cincinnati Center for Clinical and Translational Sciences and Training, G874743574
OpenAlex ID: W2804057145