scholarly journals Current Perspectives on Management of Type 2 Diabetes in Youth

Children ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 37
Author(s):  
Sachi Singhal ◽  
Seema Kumar
Keyword(s):  
Type 2 Diabetes ◽  
Severe Obesity ◽  
Rapid Development ◽  
Adult Onset ◽  
Socioeconomically Disadvantaged ◽  
Lifestyle Modifications ◽  
First Line ◽  
Diabetes In Youth ◽  
First Line Treatment

The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents is on the rise, and the increase in prevalence of this disorder parallels the modern epidemic of childhood obesity worldwide. T2DM affects primarily post-pubertal adolescents from ethnic/racial minorities and those from socioeconomically disadvantaged backgrounds. Youth with T2DM often have additional cardiovascular risk factors at diagnosis. T2DM in youth is more progressive in comparison to adult onset T2DM and shows lower rates of response to pharmacotherapy and more rapid development of diabetes-related complications. Lifestyle modifications and metformin are recommended as the first-line treatment for youth with T2DM in the absence of significant hyperglycemia. Assessment of pancreatic autoimmunity is recommended in all youth who appear to have T2DM. Pharmacotherapeutic options for youth with T2DM are limited at this time. Liraglutide, a GLP-1 agonist, was recently approved for T2DM in adolescents 10 years of age and older. Several clinical trials are currently underway with youth with T2DM with medications that are approved for T2DM in adults. Bariatric surgery is associated with excellent rates of remission of T2DM in adolescents with severe obesity and should be considered in selected adolescents.

scholarly journals Trends in First-Line Glucose-Lowering Drug Use in Adults With Type 2 Diabetes in Light of Emerging Evidence for SGLT-2i and GLP-1RA

2021 ◽  
Author(s):  
HoJin Shin ◽  
Sebastian Schneeweiss ◽  
Robert J. Glynn ◽  
Elisabetta Patorno
Keyword(s):  
Type 2 Diabetes ◽  
Line Treatment ◽  
Medicare Beneficiaries ◽  
First Line ◽  
Adult Type ◽  
Antidiabetic Treatment ◽  
Glucagon Like Peptide 1 ◽  
Lowering Drug ◽  
First Line Treatment

<p>Objective: We evaluated recent utilization trends and predictors of first-line antidiabetic treatment in patients with type 2 diabetes.</p> <p>Research Design and Methods: Using two large U.S. health insurance databases (Clinformatics and Medicare), we identified adult type 2 diabetes patients who initiated antidiabetic treatment from 2013 through 2019. Quarterly trends in use of first-line antidiabetic treatment were plotted overall and stratified by cardiovascular disease (CVD). Multinomial logistic regressions were fit to estimate predictors of first-line antidiabetic treatment, using metformin, the recommended first-line treatment for type 2 diabetes, as the common referent.</p> <p>Results: Metformin was the most frequently initiated medication used by 80.6% of Medicare beneficiaries and 83.1% of commercially insured patients. Sulfonylureas were used by 8.7% (Medicare) and 4.7% (commercial). Both populations had low use of sodium-glucose cotransporter 2 inhibitors (SGLT-2i, 0.8% [Medicare] and 1.7% [commercial]) and glucagon-like peptide 1 receptor agonists (GLP-1RA, 1.0% [Medicare] and 3.5% [commercial]), with increasing trends over time (P < 0.01). Initiators of antidiabetic drugs with established cardiovascular benefits (SGLT-2i and GLP-1RA) were more likely to be younger, and had prevalent CVD or higher socioeconomic status compared with initiators of metformin. </p> <p>Conclusions: Among adult patients with type 2 diabetes, metformin was by far the most frequent first-line treatment. While the use of SGLT-2i and GLP-1RA was low from 2013 through 2019, it increased among patients with CVD.</p>

First-line treatment for type 2 diabetes: is it too early to abandon metformin?

The Lancet ◽  
2020 ◽  
Vol 396 (10264) ◽  
pp. 1705-1707
Author(s):  
Francesco Zaccardi ◽  
Kamlesh Khunti ◽  
Nikolaus Marx ◽  
Melanie J Davies
Keyword(s):  
Type 2 Diabetes ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

Effect of severe obesity in childhood and adolescence on risk of type 2 diabetes in youth and early adulthood in an American Indian population

2017 ◽  
Vol 19 (4) ◽  
pp. 622-629 ◽  
Author(s):  
Stephanie K Tanamas ◽  
Sanil P Reddy ◽  
Melissa A Chambers ◽  
Elena J Clark ◽  
Diana L Dunnigan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
American Indian ◽  
Indian Population ◽  
Severe Obesity ◽  
Early Adulthood ◽  
Childhood And Adolescence ◽  
American Indian Population ◽  
Diabetes In Youth

scholarly journals Trends in First-Line Glucose-Lowering Drug Use in Adults With Type 2 Diabetes in Light of Emerging Evidence for SGLT-2i and GLP-1RA

2021 ◽  
Author(s):  
HoJin Shin ◽  
Sebastian Schneeweiss ◽  
Robert J. Glynn ◽  
Elisabetta Patorno
Keyword(s):  
Type 2 Diabetes ◽  
Line Treatment ◽  
Medicare Beneficiaries ◽  
First Line ◽  
Adult Type ◽  
Antidiabetic Treatment ◽  
Glucagon Like Peptide 1 ◽  
Lowering Drug ◽  
First Line Treatment

<p>Objective: We evaluated recent utilization trends and predictors of first-line antidiabetic treatment in patients with type 2 diabetes.</p> <p>Research Design and Methods: Using two large U.S. health insurance databases (Clinformatics and Medicare), we identified adult type 2 diabetes patients who initiated antidiabetic treatment from 2013 through 2019. Quarterly trends in use of first-line antidiabetic treatment were plotted overall and stratified by cardiovascular disease (CVD). Multinomial logistic regressions were fit to estimate predictors of first-line antidiabetic treatment, using metformin, the recommended first-line treatment for type 2 diabetes, as the common referent.</p> <p>Results: Metformin was the most frequently initiated medication used by 80.6% of Medicare beneficiaries and 83.1% of commercially insured patients. Sulfonylureas were used by 8.7% (Medicare) and 4.7% (commercial). Both populations had low use of sodium-glucose cotransporter 2 inhibitors (SGLT-2i, 0.8% [Medicare] and 1.7% [commercial]) and glucagon-like peptide 1 receptor agonists (GLP-1RA, 1.0% [Medicare] and 3.5% [commercial]), with increasing trends over time (P < 0.01). Initiators of antidiabetic drugs with established cardiovascular benefits (SGLT-2i and GLP-1RA) were more likely to be younger, and had prevalent CVD or higher socioeconomic status compared with initiators of metformin. </p> <p>Conclusions: Among adult patients with type 2 diabetes, metformin was by far the most frequent first-line treatment. While the use of SGLT-2i and GLP-1RA was low from 2013 through 2019, it increased among patients with CVD.</p>

scholarly journals Cardiovascular Risk Associated With Acarbose Versus Metformin as the First-Line Treatment in Patients With Type 2 Diabetes: A Nationwide Cohort Study

2015 ◽  
Vol 100 (3) ◽  
pp. 1121-1129 ◽  
Author(s):  
Chia-Hsuin Chang ◽  
Yi-Cheng Chang ◽  
Jou-Wei Lin ◽  
Shu-Ting Chen ◽  
Lee-Ming Chuang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment
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