Association of Type 1 Diabetes vs Type 2 Diabetes Diagnosed During Childhood and Adolescence With Complications During Teenage Years and Young Adulthood

Dabelea, Dana; Stafford, Jeanette M.; Mayer‐Davis, Elizabeth J.; D’Agostino, Ralph B.; Dolan, Lawrence M.; Imperatore, Giuseppina; Linder, Barbara; Lawrence, Jean M.; Marcovina, Santica M.; Mottl, Amy K.; Black, Maureen M.; Pop‐Busui, Rodica; Saydah, Sharon; Hamman, Richard F.; Pihoker, Catherine

doi:10.1001/jama.2017.0686

Cited by 532 publications

(521 citation statements)

References 38 publications

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“…This likely contributes to the higher prevalence of micro- and macrovascular complications in youth with T2D. 21 Given the associations between excess weight accumulation and CVD risk factors and the rising prevalence of high WC in youth with T2D, this study provides further evidence that a foundational treatment goal is to attain a healthier weight.…”

Section: Discussionmentioning

confidence: 72%

Trends in Prevalence of Cardiovascular Risk Factors from 2002‐2012 among Youth Early in the Course of Type 1 and Type 2 Diabetes. The SEARCH for Diabetes in Youth Study

et al. 2019

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Background: Given diabetes is an important risk factor for cardiovascular disease (CVD), we examined temporal trends in CVD risk factors by comparing youth recently diagnosed with type 1 diabetes (T1D) and type 2 diabetes (T2D) from 2002 through 2012. Methods: The SEARCH for Diabetes in Youth Study identified youth with diagnosed T1D (n = 3954) and T2D (n = 706) from 2002 to 2012. CVD risk factors were defined using the modified Adult Treatment Panel III criteria for metabolic syndrome: (a) hypertension; (b) high-density lipoprotein cholesterol ≤40 mg/dL; (c) triglycerides ≥110 mg/dL; and (d) waist circumference (WC) >90th percentile. Prevalence of CVD risk factors, stratified by diagnosis year and diabetes type, was reported. Univariate and multivariate logistic models and Poisson regression were fit to estimate the prevalence trends for CVD risk factors individually and in clusters (≥2 risk factors). Results: The prevalence of ≥2 CVD risk factors was higher in youth with T2D than with T1D at each incident year, but the prevalence of ≥2 risk factors did not change across diagnosis years among T1D or T2D participants. The number of CVD risk factors did not change significantly in T1D participants, but increased at an annual rate of 1.38% in T2D participants. The prevalence of hypertension decreased in T1D participants, and high WC increased in T2D participants. Conclusion: The increase in number of CVD risk factors including large WC among youth with T2D suggests a need for early intervention to address these CVD risk factors. Further study is needed to examine longitudinal associations between diabetes and CVD.

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Section: Discussionmentioning

confidence: 72%

Trends in Prevalence of Cardiovascular Risk Factors from 2002‐2012 among Youth Early in the Course of Type 1 and Type 2 Diabetes. The SEARCH for Diabetes in Youth Study

et al. 2019

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“…These findings are consistent with a recent study demonstrating a higher incidence of microvascular complications including peripheral neuropathy in patients with type 2 compared to type 1 diabetes. 35 However, our findings need to be interpreted cautiously given the small number of subjects in each group.…”

Section: Discussionmentioning

confidence: 79%

In-vivo reflectance confocal microscopy of Meissner's corpuscles in diabetic distal symmetric polyneuropathy

Creigh

McDermott

Sowden

et al. 2017

Journal of the Neurological Sciences

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Objective To evaluate in-vivo reflectance confocal microscopy (RCM) of Meissner’s corpuscles (MC) in diabetic distal symmetric polyneuropathy (DSP). Methods Forty-three adults with diabetes and 21 control subjects underwent RCM of MC density at the fingertip of digit V, thenar eminence (TE), and arch of the foot, ankle skin biopsy for epidermal nerve fiber density (ENFD), electrophysiological studies, monofilament threshold testing, and timed vibration at the toe. Subjects with diabetes were subdivided into groups with and without clinical DSP using the American Academy of Neurology (AAN) case definition and neuropathy outcomes were compared across groups. Results Both diabetic groups (with and without AAN clinical DSP criteria) had objective evidence of peripheral sensory involvement using conventional sensory measures, although those with clinical DSP criteria had greater abnormalities. MC densities were lower in the entire diabetic group at the TE and digit V relative to controls. MC densities at all imaging sites were associated with corresponding conventional sensory measures. MC densities were reduced in subjects without AAN clinical DSP criteria at the TE and digit V compared to controls whereas conventional upper limb sensory measures did not differ between these groups. Conclusions In-vivo RCM of MC density at digit V is a non-invasive, painless, objective marker in diabetes that offers a window into early large fiber sensory nerve terminal loss. Further studies are needed to determine whether RCM of MCs can identify quantitative changes in DSP associated with disease progression or treatment.

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“…In a separate analysis of longitudinal data from the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study, the prevalence of increased albumin excretion rose from 6.3% of participants at baseline to 16.6% at 3.9 years follow-up (3) and 18.0% at 5 years follow-up (4). In the SEARCH study, the age-adjusted prevalence of DKD in youth with T2D was 20%, which was significantly greater than DKD in youth with T1D (6%, p<0.001) (24). Moreover, after multivariable adjustment for established risk factors measured over time, youth with T2D vs. those with T1D had over 2-fold greater odds DKD (OR: 2.58; 95% CI, 1.39, 4.81; p=0.003) (24).…”

Section: The Risk Of Dkd In Youth-onset T2dmentioning

confidence: 99%

“…In the SEARCH study, the age-adjusted prevalence of DKD in youth with T2D was 20%, which was significantly greater than DKD in youth with T1D (6%, p<0.001) (24). Moreover, after multivariable adjustment for established risk factors measured over time, youth with T2D vs. those with T1D had over 2-fold greater odds DKD (OR: 2.58; 95% CI, 1.39, 4.81; p=0.003) (24). …”

Section: The Risk Of Dkd In Youth-onset T2dmentioning

confidence: 99%

“…These studies have established that intrarenal hemodynamic dysfunction is common (8, 52, 54, 55), and may be reversed with therapeutic agents early in the course of the disease (10, 50). Yet no such data are available for youth-onset T2D, a disease that carries a significantly high risk of progressive DKD (22–24, 56–63). Knowledge gaps and specific research priorities to prevent or delay the development of DKD in youth with T2D are listed in Table 1.…”

Section: Current Unmet Needs: Dkd and Youth Onset T2dmentioning

confidence: 99%

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Renal Hyperfiltration in Adolescents with Type 2 Diabetes: Physiology, Sex Differences, and Implications for Diabetic Kidney Disease

Bjornstad

Cherney

2018

Curr Diab Rep

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Hyperfiltration is common in youth with T2D and predicts progressive DKD. Hyperfiltration is a consequence of early changes in intrarenal hemodynamic function, including increased renal plasma flow (RPF) and glomerular pressure. Girls with T2D are disproportionally affected by DKD, with a 3-fold greater risk of developing hyperfiltration over 5 years compared to boys. Despite the high prevalence and gravity of DKD in youth-onset T2D, widely effective therapeutic options are lacking. In this review, we focus on pathophysiology underlying early DKD in T2D and sex differences and summarize promising novel medical therapies and bariatric surgery.

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Association of Type 1 Diabetes vs Type 2 Diabetes Diagnosed During Childhood and Adolescence With Complications During Teenage Years and Young Adulthood

Cited by 532 publications

References 38 publications

Trends in Prevalence of Cardiovascular Risk Factors from 2002‐2012 among Youth Early in the Course of Type 1 and Type 2 Diabetes. The SEARCH for Diabetes in Youth Study

Trends in Prevalence of Cardiovascular Risk Factors from 2002‐2012 among Youth Early in the Course of Type 1 and Type 2 Diabetes. The SEARCH for Diabetes in Youth Study

In-vivo reflectance confocal microscopy of Meissner's corpuscles in diabetic distal symmetric polyneuropathy

Renal Hyperfiltration in Adolescents with Type 2 Diabetes: Physiology, Sex Differences, and Implications for Diabetic Kidney Disease

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