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Hormone research in pædiatrics : from developmental endocrinology to clinical research v.89 no.1, 2018년, pp.47 - 55   SCI SCIE
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Initial Presentation of Type 2 Diabetes in Adolescents Predicts Durability of Successful Treatment with Metformin Monotherapy: Insights from the Pediatric Diabetes Consortium T2D Registry

Bacha, Fida Cheng, Peiyao Gal, Robin L. Kollman, Craig Tamborlane, William V. Klingensmith, Georgeanna J. Manseau, Katherine Wood, Jamie Beck, Roy W.
  • 초록  

    Background/Aims: Many adolescents with type 2 diabetes (T2D) have rapid deterioration of glycemic control on metformin monotherapy within 2 years of diagnosis. Methods: Enrollment data from the Pediatric Diabetes Consortium T2D Registry were used to categorize 276 youth with a T2D duration ≥2 years into two groups: (1) participants with HbA 1c <7.5% on metformin monotherapy (group 1, n = 75) and (2) participants treated with insulin ± metformin (group 2, n = 201). The characteristics of the groups were compared. Results: At enrollment, groups 1 and 2 did not differ in age (16.2 vs. 16.8 years) or BMI percentile (99 vs. 98%); group 2 had higher HbA 1c (9.9% [85 mmol/mol] vs. 5.9% [41 mmol/mol], p < 0.001). Lower HbA 1c and metformin monotherapy at diagnosis were associated with a greater likelihood of adequate control with metformin alone ( p < 0.001). In multivariable analysis, HbA 1c at diagnosis ( p = 0.001) and diabetes duration ( p = 0.009) were associated with adequate control on metformin. The HbA 1c trajectory after diagnosis was worse in group 2. Conclusion: Durable metabolic control of T2D with metformin monotherapy is most likely in youth presenting with lower HbA 1c and with shorter diabetes duration, independent of age, race-ethnicity, and BMI. Elevated HbA 1c levels in those on insulin therapy highlight the importance of early diagnosis and a better understanding of glycemic control barriers.


  • 주제어

    Diabetes .   Children .   Type 2 .   HbA1c .   Glycemic control.  

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