Kristina M Utzschneider1, Mark T Tripputi2, Alexandra Kozedub3, Elena Barengolts4, Sonia Caprio5, Melanie Cree-Green6, Sharon L Edelstein2, Laure El Ghormli2, Tamara S Hannon7, Kieren J Mather7, Jerry Palmer1, Kristen J Nadeau6. 1. VA Puget Sound Health Care System, Seattle, WA, United States; Department of Medicine, University of Washington, Seattle, WA, United States. 2. George Washington University Biostatistics Center, Rockville, MD, United States. 3. VA Puget Sound Health Care System, Seattle, WA, United States. 4. Jesse Brown VA Medical Center, Chicago, IL, United States. 5. Department of Pediatrics, Yale University, New Haven, CT, United States. 6. University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, Denver, CO, United States. 7. Indiana University School of Medicine, Indianapolis, IN, United States.
Abstract
AIMS: To compare OGTT-derived estimates of β-cell function between youth and adults with impaired glucose tolerance (IGT) or recently diagnosed type 2 diabetes after treatment discontinuation in RISE. METHODS: Youth (n = 89) and adults (n = 132) were randomized to 3 months glargine followed by 9 months metformin (G/M) or 12 months metformin (MET). Insulin sensitivity and β-cell responses were estimated from 3-hour OGTTs over 21 months. Linear mixed models tested for differences by time and age group within each treatment arm. RESULTS: After treatment withdrawal, HbA1c increased in both youth and adults with a larger net increase in G/M youth vs. adults at 21 months. Among youth, β-cell function decreased starting at 12 months in G/M and 15 months in MET. Among adults, β-cell function remained relatively stable although insulin secretion rates decreased in G/M at 21 months. At 21 months vs. baseline β-cell function declined to a greater extent in youth vs. adults in both the G/M and MET treatment arms. CONCLUSIONS: After treatment withdrawal youth demonstrated progressive decline in β-cell function after stopping treatment with either G/M or MET. In contrast, β-cell function in adults remained stable despite an increase in HbA1c over time. ClinicalTrials.gov Identifier: NCT01779375 and NCT01779362 at clinical trials.gov.
AIMS: To compare OGTT-derived estimates of β-cell function between youth and adults with impaired glucose tolerance (IGT) or recently diagnosed type 2 diabetes after treatment discontinuation in RISE. METHODS: Youth (n = 89) and adults (n = 132) were randomized to 3 months glargine followed by 9 months metformin (G/M) or 12 months metformin (MET). Insulin sensitivity and β-cell responses were estimated from 3-hour OGTTs over 21 months. Linear mixed models tested for differences by time and age group within each treatment arm. RESULTS: After treatment withdrawal, HbA1c increased in both youth and adults with a larger net increase in G/M youth vs. adults at 21 months. Among youth, β-cell function decreased starting at 12 months in G/M and 15 months in MET. Among adults, β-cell function remained relatively stable although insulin secretion rates decreased in G/M at 21 months. At 21 months vs. baseline β-cell function declined to a greater extent in youth vs. adults in both the G/M and MET treatment arms. CONCLUSIONS: After treatment withdrawal youth demonstrated progressive decline in β-cell function after stopping treatment with either G/M or MET. In contrast, β-cell function in adults remained stable despite an increase in HbA1c over time. ClinicalTrials.gov Identifier: NCT01779375 and NCT01779362 at clinical trials.gov.
Authors: Kristina M Utzschneider; Mark T Tripputi; Alexandra Kozedub; Kieren J Mather; Kristen J Nadeau; Sharon L Edelstein; Tamara S Hannon; Silva A Arslanian; Melanie Cree-Green; Thomas A Buchanan; Sonia Caprio; Andrea Mari Journal: Pediatr Diabetes Date: 2020-10-14 Impact factor: 4.866
Authors: Amy S Shah; Scott Isom; Ralph D'Agostino; Lawrence M Dolan; Dana Dabelea; Giuseppina Imperatore; Amy Mottl; Eva Lustigova; Catherine Pihoker; Santica Marcovina; Elaine M Urbina Journal: Diabetes Care Date: 2022-07-07 Impact factor: 17.152