Bimota Nambam1, Janet Silverstein1, Peiyao Cheng2, Katrina J Ruedy2, Roy W Beck2, R Paul Wadwa3, Georgeanna Klingensmith3, Steven M Willi4, Jamie R Wood5, Fida Bacha6, Inas H Thomas7, William V Tamborlane8. 1. Pediatric Endocrinology, University of Florida, Gainesville, FL, USA. 2. Jaeb Center for Health Research, Tampa, FL, USA. 3. Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO, USA. 4. Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 5. Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA. 6. USDA/ARS Children's Nutrition Research Center, and Pediatric Diabetes and Endocrinology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA. 7. Pediatric Endocrinology, University of Michigan, Ann Arbor, MI, USA. 8. Pediatric Endocrinology, Yale University, New Haven, CT, USA.
Abstract
OBJECTIVE: To describe the clinical characteristics, treatment approaches, clinical outcomes, and co-morbidities of youth with type 2 diabetes (T2D) enrolled in the Pediatric Diabetes Consortium (PDC) T2D Registry. METHODS: PDC enrolled 598 youth <21 yr of age with T2D from February 2012 to July 2015 at eight centers. Data were collected from medical records and interviews with participants and/or parents and included glycated hemoglobin (HbA1c), diabetes treatments, prevalence of diabetes comorbidities (hypertension (HTN), dyslipidemia (DL), microalbuminuria (MA), and nonalcoholic fatty liver disease (NAFLD). RESULTS: Insulin use was observed in 45% of those with T2D duration <1 yr, 44% for 1-<2 yr, 55% for 2-3 yr and 60% for ≥4 yr. Median HbA1c was 6.7% (50 mmol/mol), 8.5% (69 mmol/mol), 9.6% (81 mmol/mol), and 9.7% (82 mmol/mol) in those with disease duration <1, 1-<2, 2-3 and ≥4 yr, respectively. Only 33 and 11% of those with HTN and DL respectively, were being treated. MA and NAFLD were observed in 5-6% of the participants. Prevalence of HTN was associated with higher BMI (p < 0.001), DL with higher HbA1c (p < 0.001), and MA with longer diabetes duration (p = 0.001). CONCLUSIONS: Frequency of insulin therapy in youth with T2D was associated with increased disease duration and those with longer duration rarely achieve target HbA1c level. This highlights the aggressive course of T2D in youth and adolescents. Additionally, co-morbidities are not being adequately treated. Follow up data from the PDC will provide additional important information about the natural history of T2D and patterns of gaps in treatment.
OBJECTIVE: To describe the clinical characteristics, treatment approaches, clinical outcomes, and co-morbidities of youth with type 2 diabetes (T2D) enrolled in the Pediatric Diabetes Consortium (PDC) T2D Registry. METHODS: PDC enrolled 598 youth <21 yr of age with T2D from February 2012 to July 2015 at eight centers. Data were collected from medical records and interviews with participants and/or parents and included glycated hemoglobin (HbA1c), diabetes treatments, prevalence of diabetes comorbidities (hypertension (HTN), dyslipidemia (DL), microalbuminuria (MA), and nonalcoholic fatty liver disease (NAFLD). RESULTS: Insulin use was observed in 45% of those with T2D duration <1 yr, 44% for 1-<2 yr, 55% for 2-3 yr and 60% for ≥4 yr. Median HbA1c was 6.7% (50 mmol/mol), 8.5% (69 mmol/mol), 9.6% (81 mmol/mol), and 9.7% (82 mmol/mol) in those with disease duration <1, 1-<2, 2-3 and ≥4 yr, respectively. Only 33 and 11% of those with HTN and DL respectively, were being treated. MA and NAFLD were observed in 5-6% of the participants. Prevalence of HTN was associated with higher BMI (p < 0.001), DL with higher HbA1c (p < 0.001), and MA with longer diabetes duration (p = 0.001). CONCLUSIONS: Frequency of insulin therapy in youth with T2D was associated with increased disease duration and those with longer duration rarely achieve target HbA1c level. This highlights the aggressive course of T2D in youth and adolescents. Additionally, co-morbidities are not being adequately treated. Follow up data from the PDC will provide additional important information about the natural history of T2D and patterns of gaps in treatment.
Authors: Faisal S Malik; Katherine A Sauder; Scott Isom; Beth A Reboussin; Dana Dabelea; Jean M Lawrence; Alissa Roberts; Elizabeth J Mayer-Davis; Santica Marcovina; Lawrence Dolan; Daria Igudesman; Catherine Pihoker; Jean M Lawrence; Peggy Hung; Corinna Koebnick; Xia Li; Eva Lustigova; Kristi Reynolds; David J Pettitt; Elizabeth J Mayer-Davis; Amy Mottl; Joan Thomas; Malaka Jackson; Lisa Knight; Angela D Liese; Christine Turley; Deborah Bowlby; James Amrhein; Elaine Apperson; Bryce Nelson; Dana Dabelea; Anna Bellatorre; Tessa Crume; Richard F Hamman; Katherine A Sauder; Allison Shapiro; Lisa Testaverde; Georgeanna J Klingensmith; David Maahs; Marian J Rewers; Paul Wadwa; Stephen Daniels; Michael G Kahn; Greta Wilkening; Clifford A Bloch; Jeffrey Powell; Kathy Love-Osborne; Diana C Hu; Lawrence M Dolan; Amy S Shah; Debra A Standiford; Elaine M Urbina; Catherine Pihoker; Irl Hirsch; Grace Kim; Faisal A Malik; Lina Merjaneh; Alissa Roberts; Craig Taplin; Joyce Yi-Frazier; Natalie Beauregard; Cordelia Franklin; Carlo Gangan; Sue Kearns; Mary Klingsheim; Beth Loots; Michael Pascual; Carla Greenbaum; Giuseppina Imperatore; Sharon H Saydah; Barbara Linder; Santica M Marcovina; Alan Chait; Noemie Clouet-Foraison; Jessica Harting; Greg Strylewicz; Ralph D'Agostino; Elizabeth T Jensen; Lynne E Wagenknecht; Ronny A Bell; Ramon Casanova; Jasmin Divers; Maureen T Goldstein; Leora Henkin; Scott Isom; Kristin Lenoir; June Pierce; Beth Reboussin; Joseph Rigdon; Andrew Michael South; Jeanette Stafford; Cynthia Suerken; Brian Wells; Carrie Williams Journal: Diabetes Care Date: 2022-02-01 Impact factor: 19.112
Authors: Katherine A Sauder; Jeanette M Stafford; Shelley Ehrlich; Jean M Lawrence; Angela D Liese; Santica Marcovina; Amy K Mottl; Catherine Pihoker; Sharon Saydah; Amy S Shah; Ralph B D'Agostino; Dana Dabelea Journal: Diabetes Care Date: 2021-08-10 Impact factor: 17.152
Authors: Megan O Bensignor; Eric M Bomberg; Carolyn T Bramante; T V S Divyalasya; Paula M Hale; Chethana K Ramesh; Kyle D Rudser; Aaron S Kelly Journal: Pediatr Obes Date: 2021-02-25 Impact factor: 3.910
Authors: Angela D Liese; Xiaonan Ma; Lauren Reid; Melanie W Sutherland; Bethany A Bell; Jan M Eberth; Janice C Probst; Christine B Turley; Elizabeth J Mayer-Davis Journal: Pediatr Diabetes Date: 2019-02-19 Impact factor: 3.409