demonstrating differences in complication rates between youth and adults with type 2 diabetes of known duration.
One thing that’ s clear is that, for the youth cohort, those rates are higher, and the complications more severe, than anyone suspected 15 years ago – and they start earlier. For Dr. Zeitler and the TODAY team, the next step will be to study new cohorts starting at younger ages to understand why some kids with obesity get diabetes and others don’ t.
“ If you can ID who’ s at risk, you can start developing more effective interventions,” he says.
He’ s currently seeking funding for those studies from the National Institute of Diabetes and Digestive and Kidney Diseases, the same National Institutes of Health branch that funded TODAY and TODAY2.
Until then, the work continues.•
1. TODAY Study Group, Zeitler P, Hirst K, Pyle L, Linder B, Copeland K, Arslanian S, Cuttler L, Nathan DM, Tollefsen S, Wilfley D, Kaufman F. A clinical trial to maintain glycemic control in youth with type 2 diabetes. N Engl J Med. 2012 Jun 14; 366( 24): 2247-56.
2. TODAY Study Group, Bjornstad P, Drews KL, Caprio S, Gubitosi-Klug R, Nathan DM, Tesfaldet B, Tryggestad J, White NH, Zeitler P. Long-Term Complications in Youth-Onset Type 2 Diabetes. N Engl J Med. 2021 Jul 29; 385( 5): 416-426.
3. TODAY Study Group. Effects of Metabolic Factors, Race-Ethnicity, and Sex on the Development of Nephropathy in Adolescents and Young Adults With Type 2 Diabetes: Results From the TODAY Study. Diabetes Care. 2021 Sep 16.
4. Srinivasan S, Chen L, Todd J, Divers J, Gidding S, Chernausek S, Gubitosi-Klug RA, Kelsey MM, Shah R, Black MH, Wagenknecht LE, Manning A, Flannick J, Imperatore G, Mercader JM, Dabelea D, Florez JC; ProDiGY Consortium. The First Genome-Wide Association Study for Type 2 Diabetes in Youth: The Progress in Diabetes Genetics in Youth( ProDiGY) Consortium. Diabetes. 2021 Apr; 70( 4): 996-1005.
5. Inge TH, Courcoulas AP, Jenkins TM, Michalsky MP, Brandt ML, Xanthakos SA, Dixon JB, Harmon CM, Chen MK, Xie C, Evans ME, Helmrath MA; Teen – LABS Consortium. Five-Year Outcomes of Gastric Bypass in Adolescents as Compared with Adults. N Engl J Med. 2019 May 30; 380( 22): 2136-2145.
6. Bjornstad P, Hughan K, Kelsey MM, Shah AS, Lynch J, Nehus E, Mitsnefes M, Jenkins T, Xu P, Xie C, Inge T, Nadeau K. Effect of Surgical Versus Medical Therapy on Diabetic Kidney Disease Over 5 Years in Severely Obese Adolescents With Type 2 Diabetes. Diabetes Care. 2020 Jan; 43( 1): 187-195.
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