Major adverse events in youth-onset type 1 and type 2 diabetes: The SEARCH and TODAY studies

To determine contemporary incidence rates and risk factors for major adverse events in youth-onset T1D and T2D. Participant interviews were conducted once during in-person visits from 2018 to 2019 in SEARCH (T1D: N = 564; T2D: N = 149) and semi-annually from 2014 to 2020 in TODAY (T2D: N = 495). Out...

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Bibliographic Details
Published in:Diabetes research and clinical practice 2024-04, Vol.210, p.111606-111606, Article 111606
Main Authors: Mottl, Amy K., Tryggestad, Jeanie B., Isom, Scott, Gubitosi-Klug, Rose A., Henkin, Leora, White, Neil H., D'Agostino, Ralph, Hughan, Kara S., Dolan, Lawrence M., Drews, Kimberly L.
Format: Article
Language:English
Subjects:
Diabetes
SEARCH Study
TODAY Study
Vascular complications
Youth onset
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Summary:To determine contemporary incidence rates and risk factors for major adverse events in youth-onset T1D and T2D. Participant interviews were conducted once during in-person visits from 2018 to 2019 in SEARCH (T1D: N = 564; T2D: N = 149) and semi-annually from 2014 to 2020 in TODAY (T2D: N = 495). Outcomes were adjudicated using harmonized, predetermined, standardized criteria. Incidence rates (events per 10,000 person-years) among T1D participants were: 10.9 ophthalmologic; 0 kidney; 11.1 nerve, 3.1 cardiac; 3.1 peripheral vascular; 1.6 cerebrovascular; and 15.6 gastrointestinal events. Among T2D participants, rates were: 40.0 ophthalmologic; 6.2 kidney; 21.2 nerve; 21.2 cardiac; 10.0 peripheral vascular; 5.0 cerebrovascular and 42.8 gastrointestinal events. Despite similar mean diabetes duration, complications were higher in youth with T2D than T1D: 2.5-fold higher for microvascular, 4.0-fold higher for macrovascular, and 2.7-fold higher for gastrointestinal disease. Univariate logistic regression analyses in T1D associated age at diagnosis, female sex, HbA1c and mean arterial pressure (MAP) with microvascular events. In youth-onset T2D, composite microvascular events associated positively with MAP and negatively with BMI, however composite macrovascular events associated solely with MAP. In youth-onset diabetes, end-organ events were infrequent but did occur before 15 years diabetes duration. Rates were higher and had different risk factors in T2D versus T1D.
ISSN:0168-8227
1872-8227
DOI:10.1016/j.diabres.2024.111606