Researchers find that the rate of severe complications accelerates in young adults with early type 2 diabetes

SAN FRANCISCO, June 8, 2019 / PRNewswire / – Continuing to follow the TODAY study cohort on treatment options for type 2 diabetes in adolescents and young people (TODAY), researchers can now report on the considerable development of cardiac, ocular, nerve and pregnancy in young adults with type 2 diabetes (Y-T2D). The results of this follow-up study, TODAY2, were presented today at the American Diabetes Association conference.^® (79th Scientific Sessions of the ADA)^® at the Moscone Convention Center San Francisco, show an accelerated rate of serious complications over the past five years and emphasize the increased need for more aggressive management of the disease to minimize or prevent the development of serious complications in people with Y-T2D.

"Our results indicate that the development of diabetes-related complications in people with the disease that occur in young people is at least as rapid as in people who develop the disease later in life. younger age, suffer from early childhood health consequences of type 2 diabetes in the very early stages of adulthood, which means that the burden of diabetes-related complications will be considerable and will require even more intense management as it gets older " Philip S. Zeitler, MD, PhD, Section Head of Pediatric Endocrinology at University of Colorado School of Medicine and Director of the Endocrinology Department of Colorado Children's Hospital.

TODAY'S HUI is the first multi-ethnic randomized trial of individuals with type 2 diabetes (T2DM) before the age of 18 (Y-T2D) and who remains unique in this area. When the study began in 2004, she had recruited 699 participants aged 10 to 17 years and was looking to compare treatment with metformin (the only FDA-approved drug for T2D in young people) at the same time. use of metformin in combination with rosiglitazone (an oral medication). improves the action of the body's own insulin) and the use of metformin as part of a lifestyle intervention program focused on weight loss through healthy eating and increased physical activity . The primary endpoint was the loss of glycemic control, defined as a glycated hemoglobin level of at least 8% for six months or sustained metabolic decompensation requiring insulin.

The results of the original TODAY study showed that metformin monotherapy was badociated with prolonged glycemic control in about half (46.5%) of children and adolescents with T2DM. The addition of rosiglitazone, but not an intensive lifestyle intervention, was superior to metformin alone. A detailed badysis of the data also showed that non-Hispanic black participants had particularly poor results, with more than 50% having A1C levels higher than desirable over the 12 months following initial metformin treatment. Other major results of today include the demonstration that pancreatic insulin secretion has decreased at a rate of 20 to 35% per year, exceeding that reported in adults. In addition, complications and comorbidities were common in this population of individuals with Y-T2D at the time of diagnosis and increased steadily over time.

By the end of the study in 2011, all TODAY participants were invited to stay in TODAY2, an observational monitoring study. Since then, 517 participants, averaging 25 years old and 12 years old on average, have been seen each year in one of 15 clinical centers, during which information was collected to help laboratory tests, echocardiograms, eye exam tests. The researchers also collected the participant's medical history at each visit to list any diabetes-related events, such as an amputation, heart disease, kidney problems or vision problems.

The findings of TODAY2 illustrate the occurrence of major diabetes-related events in this young adult population, including heart attacks, chronic kidney disease, advanced retinopathy, early signs of diabetic neuropathy, and complications in children of child-bearing age. procreate. Additional TODAY2 results indicate that more than 50% of participants had abnormal lipids and more than 60% had high blood pressure. Kidney function badessments show that nearly 40% of participants had evidence of early diabetic kidney disease and retinal examinations indicate that almost 50% of participants had evidence of diabetic retinal disease. In addition, up to 33% of participants exhibited the first signs of a diabetic nerve disease, which was more common among those whose glycemic control was worse. Of the 306 pregnancies reported by TODAY2 participants, 25% of 236 known pregnancies resulted in miscarriage or fetal death and 24% resulted in premature births.

"Many of these risk factors and these apparent complications are not being managed with the same vigor as what these data suggest is needed," said Dr. Zeitler. "For example, we found that despite high blood pressure or abnormal lipids, less than half of the participants were taking medications to treat these problems." TODAY2 data suggests that health professionals need to overcome Hesitation, whether because of young age or lack of familiarity with pharmacotherapy – aggressively treating young patients with early type 2 diabetes to minimize the damage caused by the serious complications of diabetes. Intensive management is based on coordinated care provided by teams of providers who are familiar with the unique aspects of management and care guidelines for this population. "

To speak with Dr. Zeitler, please contact the ADA Press Office at the following site: From San Francisco Moscone Convention Center on June 7-11, by phone at 415-978-3606 or by email at [email protected].

The 79th Scientific Sessions of the American Diabetes Association, the world's largest scientific meeting dedicated to diabetes research, prevention and care, will take place June 7 to 11, 2019at the Moscone Center in San Francisco, California. Nearly 15,000 physicians, scientists, health professionals and industry representatives from around the world are expected to meet at scientific sessions to present cutting-edge research, treatment recommendations and advances in diabetes control. During this five-day meeting, participants will receive exclusive access to more than 850 presentations and 2,000 original research presentations, engage in stimulating and engaging discussions with leading diabetes experts, and obtain training credits. Continuing Education (FMC) or Continuing Education (CE). for educational sessions. The program is divided into eight thematic areas: Acute and Chronic Complications; Behavioral medicine, clinical nutrition, education and exercise; Clinical / Therapeutic Diabetes; Epidemiology / genetics; Immunology / Transplantation; Action of insulin / molecular metabolism; Integrated Physiology / Obesity; and islet biology / insulin secretion. Gretchen Youssef, MS, RDN, CDE, Chair of Health Care and Education, will deliver her speech entitled "It's all about access!", The Saturday, June 8, and Louis H. Philipson, MD, PhD, FACP, President of Medicine and Science, will give his lecture entitled "Precision Medicine – Addressing the Multiple Facets of Diabetes", the Sunday, June 9. Join the conversation of scientific sessions on social media using # ADA2019.

About the American Diabetes Association
Every day, more than 4,000 people are diagnosed with diabetes in America. Nearly 115 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the country's leading volunteer health organization that fights to counter the diabetes epidemic and help people living with diabetes to flourish. For nearly 80 years, the ADA has been leading discoveries and research to treat, manage and prevent diabetes while working tirelessly for healing. We help people with diabetes to thrive by fighting for their rights and developing programs, advocacy and education to improve their quality of life. Diabetes has brought us together. What we do next will make us connected for life. For more information or to get involved, visit our website at diabete.org or call 1-800-DIABETES (1-800-342-2383). The information is available in English and Spanish. Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).

SOURCE American Diabetes Association

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