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Title: Determinants of glycemic control in youth with type 2 diabetes at randomization in the TODAY study

Author
item BACHA, FIDA - Children'S Nutrition Research Center (CNRC)
item PYLE, LAURA - George Washington University
item NADEAU, KRISTEN - University Of Colorado
item CUTTLER, LEONA - Case Western Reserve University (CWRU)
item GOLAND, ROBIN - Columbia University
item HAYMOND, MOREY - Children'S Nutrition Research Center (CNRC)
item LEVITSKY, LYNNE - Massachusetts General Hospital
item LYNCH, JANE - University Of Texas Health Science Center
item WEINSTOCK, RUTH - State University Of New York (SUNY)
item WHITE, NEIL - Washington University
item CAPRIO, SONIA - Yale University
item ARSLANIAN, SILVA - University Of Pittsburgh Medical Center

Submitted to: Pediatric Diabetes
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/17/2011
Publication Date: 8/1/2012
Citation: Bacha, F., Pyle, L., Nadeau, K., Cuttler, L., Goland, R., Haymond, M., Levitsky, L., Lynch, J., Weinstock, R.S., White, N.H., Caprio, S., Arslanian, S. 2012. Determinants of glycemic control in youth with type 2 diabetes at randomization in the TODAY study. Pediatric Diabetes. 13(5):377-384.

Interpretive Summary: In children with diabetes, it is important to keep blood sugars in a good range. This study investigated the factors responsible of controlling the blood sugar level in children with type 2 diabetes. We found that the ability of the body to make insulin (a substance that helps the body use sugar) is the most important factor to keep diabetes under control. This suggests that future research should try to find out ways to preserve insulin production in children with type 2 diabetes.

Technical Abstract: The purpose of this study was to investigate insulin sensitivity and secretion indices and determinants of glycemic control in youth with recent-onset type 2 diabetes (T2DM) at randomization in the TODAY study, the largest study of youth with T2DM to date. We examined estimates of insulin sensitivity [1/fasting insulin (1/I(F)), fasting glucose/insulin (G(F)/I(F)), 1/fasting C-peptide (1/C(F)), G(F)/C(F)], beta-cell function [insulinogenic index (delta I(30)/delta G(30)), and delta C(30)/delta G(30)], and disposition index (DI) in the TODAY cohort of 704 youth (14.0 +/- 2.0 yr; diabetes duration 7.8 +/- 5.8 months; 64.9% female; 41.1% Hispanic, 31.5% Black, 19.6% White, 6.1% American Indian, and 1.7% Asian) according to hemoglobin A1c (HbA1c) quartiles at study randomization. The randomization visit followed a run-in period (median 71 d) during which glycemic control (HbA1c