Youth-Onset Type 2 Diabetes Mellitus: Lessons Learned From the TODAY Study

摘要: Type 2 diabetes mellitus is increasingly diagnosed in obese children and adolescents. Evidence suggests that this disease commonly progresses more rapidly youth compared with adults associated high rates of early microalbuminuria, hypertension, dyslipidemia. The Treatment Options for Diabetes Adolescents Youth (TODAY) study was the first multiethnic, multicenter randomized trial United States to compare 3 treatment approaches new-onset type (n=699; ages 10-17 years): monotherapy metformin, metformin rosiglitazone, an intensive lifestyle intervention. primary outcome glycemic control. Diabetes-related complications cardiovascular risk factors were also examined. Approximately half participants could not maintain control by using alone. Combination therapy rosiglitazone resulted better durability control, plus intervention intermediate but superior Deterioration rapid loss beta cell function, worsened insulin sensitivity, be explained differences adherence or body mass index. After 3.9 years, 236 (33.8%) had hypertension 116 (16.6%) microalbuminuria. Only 55.9% a low-density lipoprotein cholesterol level less than 100 mg/dL (to convert mmol/L, multiply 0.0259) after 71 517 (13.7%) retinopathy. significance findings from important management young youth-onset its discussed. An aggressive multifaceted approach needed prevent forestall premature microvascular macrovascular diabetes.