People with type 2 diabetes diagnosed during youth have a high risk of developing complications at early ages and have a greater chance of multiple complications within 15 years after diagnosis, according to results of the NIDDK-funded Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) follow-up study, called TODAY2. Findings from this study underscore the importance of early, intensive treatment for those diagnosed with youth-onset type 2 diabetes.

TODAY2 involved 500 original participants from the TODAY study, which began in 2004. TODAY was the first major comparative effectiveness trial for the treatment of type 2 diabetes in youth. Participants in TODAY2 were monitored annually for signs of diabetes complications, including heart disease, kidney disease, and diabetic foot complications, and to report other health events. Diabetic eye disease was assessed once during the study, at the 7-year study visit. The TODAY study’s diverse cohort is representative of U.S. youth diagnosed with type 2 diabetes. Study participants had regular, intensive diabetes management through the study at no cost during the original TODAY trial, which researchers noted may have actually lowered the rate of complications.

After following participants for 15 years, researchers found that 60% of participants had at least one diabetes-related complication, and nearly a third of participants had two or more complications.

“Compared to what we see in adults with type 2 diabetes, the participants in TODAY2 developed complications much earlier in their disease course and at a much faster pace over time,” said TODAY2 study chair Philip Zeitler, MD, PhD, professor of Pediatrics-Endocrinology at the University of Colorado School of Medicine. “This study shows the importance of treating youth-onset type 2 diabetes intensively from the beginning and using all available approaches to control blood glucose and prevent, delay, or aggressively treat developing complications.”

The hope is that the TODAY2 findings will help find improved prevention methods, and also lead to future discoveries of new and better treatments to manage type 2 diabetes in youth.

The results of this NIDDK-funded study were published in the New England Journal of Medicine. For more information about the study, read the full NIH press release.