Skip to main content
ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #330089
Title: A cross-sectional view of the current state of treatment of youth with type 2 diabetes in the USA: Enrollment data from the Pediatric Diabetes Consortium type 2 diabetes registry

Author
item NAMBAM, BIMOTA - University Of Florida
item SILVERSTEIN, JANET - University Of Florida
item CHENG, PEIYAO - Jaeb Center For Health Research
item RUEDY, KATRINA - Jaeb Center For Health Research
item BECK, ROY - Jaeb Center For Health Research
item PAUL WADWA, R - University Of Colorado
item KLINGENSMITH, GEORGEANNA - University Of Colorado
item WILLI, STEVEN - Children'S Hospital - Philadelphia, Pennsylvania
item WOOD, JAMIE - Children'S Hospital Los Angeles
item BACHA, FIDA - Children'S Nutrition Research Center (CNRC)
item THOMAS, INAS - University Of Michigan
item TAMBORLANE, WILLIAM - Yale University

Submitted to: Pediatric Diabetes
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/16/2016
Publication Date: 3/11/2016
Citation: Nambam, B., Silverstein, J., Cheng, P., Ruedy, K.J., Beck, R.W., Paul Wadwa, R., Klingensmith, G., Willi, S.M., Wood, J.R., Bacha, F., Thomas, I.H., Tamborlane, W.V. 2016. A cross-sectional view of the current state of treatment of youth with type 2 diabetes in the USA: Enrollment data from the Pediatric Diabetes Consortium type 2 diabetes registry. Pediatric Diabetes. doi:10.1111/pedi.12377.

Interpretive Summary: The characteristics of children with type 2 diabetes (T2D) are not very well known. We used the Pediatric Diabetes Consortium (PDC) T2D Registry to understand better the diabetes control and the presence of associated illnesses in these children. We found that a large number of children did not have good control of diabetes. This worsened with the increase in the duration of the disease, necessitating insulin therapy. We observed that only a third of children with a diagnosis of hypertension were being treated for it and only 10% with those with lipid abnormalities were on lipid lowering medications. The high blood pressure was mainly related to body mass index and the abnormalities in lipids were related to diabetes control. The presence of early kidney disease correlated with the duration of the disease. We concluded that T2D in youth seems to have a more aggressive course than in adults and there is need to treat complications of the disease more aggressively.

Technical Abstract: 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. 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). Insulin use was observed in 45% of those with T2D duration <1yr, 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 >/= 4yr, 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). 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.