Progression from prediabetes to type 2 diabetes mellitus in adolescents: a real world experience

Frontiers in Clinical Diabetes and Healthcare

Clinical Diabetes and Healthcare

Beverly Tchang¹  Alyson Weiner¹  Rachelle Gandica²  Meng Zhang³  Jaime Murillo³  Sheng Ren³ 

[1] Comprehensive Weight Control Center, Division of Endocrinology, Diabetes, and Metabolism Weill Cornell Medicine, New York, NY, United States;Division of Pediatric Endocrinology, Diabetes, and Metabolism Columbia University Irving Medical Center, New York, NY, United States;Optum Labs, Eden Prairie, MN, United States;

关键词: prediabetes;    adolescents;    metformin;    type 2 diabetes;    pediatric diabetes care;   

DOI  :  10.3389/fcdhc.2023.1181729

 received in 2023-03-07, accepted in 2023-04-24,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundObesity in pediatric patients is strongly associated with increased vascular and metabolic risk. Prediabetes is present in up to 1 in 5 adolescents, aged 12-18 years-old, though is thought to remit spontaneously in a significant portion. Pediatric patients with type 2 diabetes mellitus (T2D) have a more rapid decline of beta-cell function and progression to treatment failure than adult T2D patients. Thus, there is a strong interest in better understanding the natural history of prediabetes in these youth. We aimed to evaluate the real-world rate of progression of prediabetes to T2D in adolescent patients.MethodsThis is a retrospective study of 9,275 adolescent subjects aged 12-21 years-old with at least 3 years of de-identified commercial claims data and a new diagnosis of prediabetes during the observation period. Enrollees with a T2D diagnosis and/or diabetes medication use in the 1 year prior to prediabetes diagnosis or a T2D diagnosis in the 1 month following prediabetes diagnosis were excluded. Enrollees with diagnoses of type 1 diabetes (T1D) or polycystic ovarian syndrome over the 3 years were also excluded. Progression to T2D was defined by claims data of two T2D diagnoses at least 7 days apart, HbA1c ≥6.5%, and/or prescription of insulin without known T1D. Enrollees were followed for 2 years after prediabetes diagnosis.ResultsOverall, 232 subjects (2.5%) progressed from prediabetes to T2D. There were no differences found in T2D progression based on sex or age. Progression to T2D occurred at a median of 302 days after prediabetes diagnosis (IQR 123 to 518 days). This study was limited by the lack of laboratory/anthropometric data in administrative claims, as well as the exclusion of 23,825 enrollees for lack of continuous commercial claims data over 3 years.ConclusionIn the largest sample to date on adolescent prediabetes, we found a 2.5% progression of prediabetes to T2D over a median duration of about one year.

【 授权许可】

Unknown   
Copyright © 2023 Weiner, Zhang, Ren, Tchang, Gandica and Murillo