Background: While consensus guidelines indicate that all youth with T2D should be treated with metformin ± insulin at diagnosis, >10% of patients were treated solely with diet/lifestyle on enrollment in the Pediatric Diabetes Consortium (PDC) T2D Registry.

Methods: Clinical data was collected on 1,324 Registry patients (age 6 to <21 years) from medical records and interviews. Data in patients not receiving drug treatment were compared to those receiving antidiabetic drug treatment using logistic regression models.

Results: Of the 1,324 Registry patients, 163 (12%) were treated with diet/lifestyle alone on enrollment. Of these, 73% of were initially treated with metformin ± insulin at diagnosis. The diet/lifestyle and drug-treated groups did not differ by age, gender, diabetes duration, or BMI (Table). However, mean A1c was lower and the proportion of patients with A1c <7.5% was higher in the diet/lifestyle alone group compared to the drug-treated group at enrollment and diagnosis (p<0.001, Table). There were site differences in prescribing drug-treatment (p<0.001) and a greater proportion of patients in the diet/lifestyle alone group were without health insurance.

Conclusion: These data indicate that a substantial proportion of youth with T2D can maintain target A1c levels <7.5% despite being weaned off glucose lowering drugs during the first 1-2 years after diagnosis
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Disclosure

W.V. Tamborlane: Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic MiniMed, Inc., Novo Nordisk Inc., Sanofi, Takeda Pharmaceutical Company Limited. P. Cheng: None. R.L. Gal: None. L.C. Beaulieu: None. C. Kollman: None. M.A. Van Name: Research Support; Self; Novo Nordisk Inc. E.M. Isganaitis: None. L.D. Mastrandrea: Advisory Panel; Self; Pediatric Diabetes Consortium. Research Support; Self; AstraZeneca, JDRF, Novo Nordisk Inc., Sanofi-Aventis, T1D Exchange. Other Relationship; Self; Novo Nordisk Inc. G.J. Klingensmith: Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Takeda Pharmaceutical Company Limited. Research Support; Self; Novo Nordisk Foundation. Stock/Shareholder; Spouse/Partner; Dexcom, Inc.

Funding

Boehringer Ingelheim; Novo Nordisk; Takeda Pharmaceutical Company Limited

© 2019 by the American Diabetes Association.
2019
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