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Multicenter Study
. 2025 Sep;39(9):109091.
doi: 10.1016/j.jdiacomp.2025.109091. Epub 2025 May 26.

High rate of complications in a real-world cohort of youth with T2D: a multicenter analysis

Dhruva Patel  1 , Amy S Shah  2 , Bliss Magella  2 , Mozhdeh Bahrainian  3 , Elizabeth A Brown  1 , T Y Alvin Liu  4 , Veeral Shah  5 , Roomasa Channa  3 , Risa M Wolf  6
Affiliations
Multicenter Study

High rate of complications in a real-world cohort of youth with T2D: a multicenter analysis

Dhruva Patel et al. J Diabetes Complications. 2025 Sep.

Abstract

Introduction: The TODAY2 study reported that 80 % of young adults with youth-onset T2D (YoT2D) had at least one diabetes comorbidity or complication at a mean duration of 13 years. Prevalence rates of comorbidities and microvascular complications in YoT2D with shorter duration and younger age is unclear, particularly in the age of new pharmacotherapies.

Methods: In a multicenter retrospective analysis, presence of comorbidities (hypertension (systolic BP > 130 or diastolic BP > 80), dyslipidemia (LDL > 130 mg/dL or triglycerides>150 mg/dL), elevated liver enzymes (AST > 25 U/L, or ALT U/L > 22 for females or >26 U/L for males)) and microvascular complications (microalbuminuria (microalbumin/creatinine ratio > 30), diabetic retinopathy) in patients with YoT2D at three academic pediatric diabetes centers were assessed. Ordinal logistic regression models assessed the associations between demographic and clinical variables and increased odds of either comorbidities or complications.

Results: The study included 298 youth (median age 16.6 years, 60 % female, 57 % Black, 14 % Hispanic). The median duration of T2D was 1.8 years, median HbA1c was 6.9 % (42 % had an HbA1c < 6.5 %). Over 80 % of patients had at least 1 comorbidity, 29 % with hypertension, 49 % with dyslipidemia, and 56 % with elevated liver enzymes. In the cohort, 21 % had at least 1 microvascular complication, 17 % with microalbuminuria, and 4.6 % with diabetic retinopathy. Proportion using GLP-1 receptor agonists and SGLT-2 inhibitors were 36 % and 7 %, respectively. Higher HbA1c and BMI increased the odds of having an additional comorbidity or complication, and longer diabetes duration increased the odds of having microvascular complications.

Conclusions: This study found comorbidities and microvascular complications in YoT2D at younger ages and short duration of diabetes despite use of new medications. Efforts are needed to improve glycemic control and other risk factors to reduce diabetes-related complications in YoT2D.

Keywords: Comorbidities; Complications; Type 2 diabetes.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Risa Wolf reports financial support was provided by National Eye Institute (R01EY033233 and R21EY036948) of the National Institutes of Health. Dr. Roomasa Channa reports financial support was provided by Research to Prevent Blindness. Dr. Roomasa Channa reports financial support was provided by National Eye Institute (K23EY030911 and R01EY035994) of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Dr. T.Y. Alvin Liu reports financial support was provided by Research to Prevent Blindness Career Development Award. Dr. Risa Wolf receives research support as the site PI of sponsored clinical trials from Novo Nordisk, Lilly Diabetes and Sanofi. The other authors have no conflict of interest to disclose. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

    1. Magge SN, Wolf RM, Pyle L, et al. The Coronavirus Disease 2019 Pandemic is Associated with a Substantial Rise in Frequency and Severity of Presentation of Youth-Onset Type 2 Diabetes. J Pediatr, 2022. 251: p. 51–59 e2. 10.1016/j.jpeds.2022.08.010 - DOI - PMC - PubMed
    1. Wagenknecht LE, Lawrence JM, Isom S, et al. Trends in incidence of youth-onset type 1 and type 2 diabetes in the USA, 2002–18: results from the population-based SEARCH for Diabetes in Youth study. Lancet Diabetes Endocrinol, 2023. 11(4): p. 242–250. 10.1016/S2213-8587(23)00025-6 - DOI - PMC - PubMed
    1. Tonnies T, Brinks R, Isom S, et al. Projections of Type 1 and Type 2 Diabetes Burden in the U.S. Population Aged <20 Years Through 2060: The SEARCH for Diabetes in Youth Study. Diabetes Care, 2023. 46(2): p. 313–320. 10.2337/dc22-0945 - DOI - PMC - PubMed
    1. Consortium R Restoring Insulin Secretion (RISE): design of studies of beta-cell preservation in prediabetes and early type 2 diabetes across the life span. Diabetes Care, 2014. 37(3): p. 780–8. 10.2337/dc13-1879 - DOI - PMC - PubMed
    1. Consortium R Metabolic Contrasts Between Youth and Adults With Impaired Glucose Tolerance or Recently Diagnosed Type 2 Diabetes: II. Observations Using the Oral Glucose Tolerance Test. Diabetes Care, 2018. 41(8): p. 1707–1716. 10.2337/dc18-0243 - DOI - PMC - PubMed

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