Objective: To describe temporal trends in glycemic control in youth-onset diabetes.

Methods: The study included 6399 SEARCH for Diabetes in Youth participants with diabetes >1 year. Visit data was categorized into 3 time periods: 2002-2007, 2008-2013, and 2014-2019 and 3 groups of diabetes duration: 1-4, 5-9, and 10+ years. Participants contributed one randomly selected data point to each duration group. Stratified multivariable regression models were used to test differences in hemoglobin A1c (A1c) over time, adjusted for site, age, sex, race/ethnicity, health insurance status, and disease duration, both overall (with repeated measures) and for each duration group.

Results: Estimated mean A1c among individuals with type 1 diabetes (T1D) was different over the three periods with a higher mean A1c in 2014-2019 and 2008-2013 versus 2002-2007 (p<0.01; Table). There was a temporal difference in mean A1c for T1D participants with diabetes for 5-9 years (p<0.01) and for T2D participants with diabetes 10+ years (p<0.01).

Conclusions: Despite increased availability of diabetes technology, newer therapies, and more aggressive glycemic targets over time, current youth and young adults with T1D in the U.S. have worse glycemic control than earlier cohorts. Similarly, participants with T2D diagnosed in childhood and diabetes duration of 10+ years exhibit the temporal trend of worse glycemic control in recent years.


F. Malik: None. K.A. Sauder: None. S. Isom: None. A.J. Roberts: None. E.J. Mayer-Davis: None. L.M. Dolan: None. D. Dabelea: None. J.M. Lawrence: None. C. Pihoker: None.


Centers for Disease Control and Prevention (1U18DP006131, U18DP006133, U18DP006134, U18DP006136, U18DP006138, U18DP006139, U18DP006136, U58/CCU019235-4, U01 DP000244, U18DP002710-01); National Institute of Diabetes and Digestive and Kidney Diseases (1UC4DK108173)

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