Young Adults With Youth-Onset Type 2 Diabetes Need Aggressive Management

Researchers at the American Diabetes Association’s 79th Scientific Sessions presented data showing an accelerated rate of serious complications within the last 5 years for young adults with youth-onset type 2 diabetes and call for more aggressive management of the disease to reduce further complications. 

The data comes from a follow-up study to the Treatment Options for Type 2 Diabetes n Adolescents and Youth (TODAY) study sponsored by the National Institutes of Health. Results from the TODAY study found that monotherapy with metformin was associated with sustained glycemic control in 46.5% of children and adolescents with type 2 diabetes. The study also found that “complications and comorbidities were found to be common in this population of individuals with youth-onset type 2 diabetes at the time of diagnosis and increased steadily over the time.”

In the TODAY2 study, researchers sought to report on the extensive development of severe renal, cardiac, eye, nerve, and pregnancy complications in early adulthood in patients with youth-onset type 2 diabetes.

 “Our findings indicate the development of diabetes-related complications in individuals with youth-onset disease is at least as rapid as it is in individuals who develop the disease later on in life. Since these individuals are battling the disease at a younger age, they are experiencing life-changing health consequences caused by type 2 diabetes at the earliest stages of adulthood. This means there will be a substantial burden of diabetes-related complications that will require even more intense management as they age,” said Philip S Zeitler, MD, PhD, section head of pediatric endocrinology at the University of Colorado School of Medicine and the chair of the department of endocrinology at the Children’s Hospital Colorado, in a press release regarding the study.

The TODAY2 study indicated that more than half of the participants presented abnormal lipids and more than 60% had high blood pressure. Twenty-five percent of study participants who reported being pregnant resulted in miscarriage or fetal death, further confirming the high-level risks.

“Many of these risk factors and overt complications are not being as vigorously managed as these data suggest is needed,” said Dr Zeitler. “For example, we found that, despite high blood pressure or abnormal lipids, fewer than half of the participants were on medications to treat these issues. The TODAY2 data suggest health care professionals need to overcome hesitancy— whether due to the young age of patients or lack of familiarity with the pharmacotherapy—to aggressively treat young patients battling Y-T2D to minimize the damage from serious diabetes-related complications. This intensive management depends on coordinated care by teams of providers familiar with the unique aspects of management and the care guidelines for this population.”—Edan Stanley