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

Details

• Alternative Title:
  Pediatr Diabetes
• Personal Author:
  Pinto, Cathy Anne ; Stafford, Jeanette M. ; Wang, Tongtong ; Shankar, R. Ravi ; Lawrence, Jean M. ; Kim, Grace ; Pihoker, Catherine ; D’Agostino, Ralph B. ; Dabelea, Dana
• Description:
  Objective
  
  The aim of the 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 two 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 chi-square, 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<0.05). 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<0.001) or insulin plus any oral diabetes medication (ODM) users (7.7% [60.4 mmol/mol], p<0.001). 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 ADA-recommended goal 7 years after diagnosis.
  
  
• Subjects:
  Adolescent Article Diabetes Mellitus Glycated Hemoglobin A Type 2 Young Adult
• Source:
  Pediatr Diabetes. 19(6):1065-1072
• Pubmed ID:
  29761619
• Pubmed Central ID:
  PMC6237662
• Document Type:
  Journal Article
• Funding:
  P30 DK057516/DK/NIDDK NIH HHS/United States ; UC4 DK108173/DK/NIDDK NIH HHS/United States ; U18 DP002710/DP/NCCDPHP CDC HHS/United States ; UL1 TR000154/TR/NCATS NIH HHS/United States ; U18 DP002714/DP/NCCDPHP CDC HHS/United States ; U01 DP000248/DP/NCCDPHP CDC HHS/United States ; U01 DP000244/DP/NCCDPHP CDC HHS/United States ; UL1 TR000062/TR/NCATS NIH HHS/United States ; U18 DP002709/DP/NCCDPHP CDC HHS/United States ; UL1 TR001425/TR/NCATS NIH HHS/United States ; UL1 TR000423/TR/NCATS NIH HHS/United States ; U01 DP000250/DP/NCCDPHP CDC HHS/United States ; U18 DP002708/DP/NCCDPHP CDC HHS/United States ; HIR 10-001/HX/HSRD VA/United States ; U01 DP000247/DP/NCCDPHP CDC HHS/United States ; U18 DP003256/DP/NCCDPHP CDC HHS/United States ; U18 DP006139/DP/NCCDPHP CDC HHS/United States ; UL1 TR000077/TR/NCATS NIH HHS/United States ; U01 DP000246/DP/NCCDPHP CDC HHS/United States ; U01 DP000254/DP/NCCDPHP CDC HHS/United States ; PA numbers 00097, DP-05-069, and DP-10-001/Centers for Disease Control and Prevention and supported by the National Institute of Diabetes and Digestive and Kidney Diseases/ ; P30 DK57516/Barbara Davis Center at the University of Colorado at Denver/ ; UL1 TR00423/Seattle Children' s Hospital and the University of Washington, NIH/NCATS/
• Volume:
  19
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:966da3c88029be10c24aa15994f66a2279ef902717787d937f2ad3524c7697ab
• Download URL:
  https://stacks.cdc.gov/view/cdc/60722/cdc_60722_DS1.pdf
• File Type:
  [PDF - 407.81 KB ]