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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.
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.
Citation | “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.”. Pediatric Diabetes. . |
Center | University of Colorado Denver |
Author | Cathy A Pinto, Jeanette M Stafford, Tongtong Wang, Ravi Shankar, Jean M Lawrence, Grace Kim, Catherine Pihoker, Ralph B D'Agostino, Dana Dabelea |
Keywords | adolescent and young adult, diabetes mellitus, Glycated Hemoglobin A, type 2 diabetes |
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 χ , 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. |
Year of Publication |
2018
|
Journal |
Pediatric diabetes
|
Date Published |
05/2018
|
ISSN Number |
1399-5448
|
DOI |
10.1111/pedi.12691
|
Alternate Journal |
Pediatr Diabetes
|
PMID |
29761619
|
PMCID |
PMC6237662
|
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