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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
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June 13 2018
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Source: Pediatr Diabetes. 19(6):1065-1072
[PDF-407.81 KB]
Details:
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Alternative Title:Pediatr Diabetes
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Personal Author:
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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.
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Pubmed ID:29761619
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Pubmed Central ID:PMC6237662
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