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Malik FS, Sauder KA, Isom S, Reboussin BA, Dabelea D, Lawrence JM, Roberts A, Mayer-Davis EJ, Marcovina S, Dolan L, Igudesman D, Pihoker C, Lawrence JM, Hung P, Koebnick C, Li X, Lustigova E, Reynolds K, Pettitt DJ, Mayer-Davis EJ, Mottl A, Thomas J, Jackson M, Knight L, Liese AD, Turley C, Bowlby D, Amrhein J, Apperson E, Nelson B, Dabelea D, Bellatorre A, Crume T, Hamman RF, Sauder KA, Shapiro A, Testaverde L, Klingensmith GJ, Maahs D, Rewers MJ, Wadwa P, Daniels S, Kahn MG, Wilkening G, Bloch CA, Powell J, Love-Osborne K, Hu DC, Dolan LM, Shah AS, Standiford DA, Urbina EM, Pihoker C, Hirsch I, Kim G, Malik FA, Merjaneh L, Roberts A, Taplin C, Yi-Frazier J, Beauregard N, Franklin C, Gangan C, Kearns S, Klingsheim M, Loots B, Pascual M, Greenbaum C, Imperatore G, Saydah SH, Linder B, Marcovina SM, Chait A, Clouet-Foraison N, Harting J, Strylewicz G, D'Agostino R, Jensen ET, Wagenknecht LE, Bell RA, Casanova R, Divers J, Goldstein MT, Henkin L, Isom S, Lenoir K, Pierce J, Reboussin B, Rigdon J, South AM, Stafford J, Suerken C, Wells B, Williams C. Trends in Glycemic Control Among Youth and Young Adults With Diabetes: The SEARCH for Diabetes in Youth Study. Diabetes Care 2022; 45:285-294. [PMID: 34995346 PMCID: PMC8914430 DOI: 10.2337/dc21-0507] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 11/15/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To describe temporal trends and correlates of glycemic control in youth and young adults (YYA) with youth-onset diabetes. RESEARCH DESIGN AND METHODS The study included 6,369 participants with type 1 or type 2 diabetes from the SEARCH for Diabetes in Youth study. Participant visit data were categorized into time periods of 2002-2007, 2008-2013, and 2014-2019, diabetes durations of 1-4, 5-9, and ≥10 years, and age groups of 1-9, 10-14, 15-19, 20-24, and ≥25 years. Participants contributed one randomly selected data point to each duration and age group per time period. Multivariable regression models were used to test differences in hemoglobin A1c (HbA1c) over time by diabetes type. Models were adjusted for site, age, sex, race/ethnicity, household income, health insurance status, insulin regimen, and diabetes duration, overall and stratified for each diabetes duration and age group. RESULTS Adjusted mean HbA1c for the 2014-2019 cohort of YYA with type 1 diabetes was 8.8 ± 0.04%. YYA with type 1 diabetes in the 10-14-, 15-19-, and 20-24-year-old age groups from the 2014-2019 cohort had worse glycemic control than the 2002-2007 cohort. Race/ethnicity, household income, and treatment regimen predicted differences in glycemic control in participants with type 1 diabetes from the 2014-2019 cohort. Adjusted mean HbA1c was 8.6 ± 0.12% for 2014-2019 YYA with type 2 diabetes. Participants aged ≥25 years with type 2 diabetes had worse glycemic control relative to the 2008-2013 cohort. Only treatment regimen was associated with differences in glycemic control in participants with type 2 diabetes. CONCLUSIONS Despite advances in diabetes technologies, medications, and dissemination of more aggressive glycemic targets, many current YYA are less likely to achieve desired glycemic control relative to earlier cohorts.
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Affiliation(s)
- Faisal S Malik
- Department of Pediatrics, University of Washington, Seattle, WA
| | - Katherine A Sauder
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO
| | - Scott Isom
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Beth A Reboussin
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO
| | - Jean M Lawrence
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Alissa Roberts
- Department of Pediatrics, University of Washington, Seattle, WA
| | | | | | - Lawrence Dolan
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Daria Igudesman
- Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill, NC
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