In youth-onset type 2 diabetes, the risk of microvascular complications increased by 27% per 1% increase in baseline HbA1c (95% CI 1.24-1.30) and by 9.2% per 10 U/L increase in ALT.
Observational (n=677)
A parametric model identified baseline ALT and HbA1c, as well as early changes in BMI, blood pressure, and HbA1c, as key predictors of microvascular complications in youth-onset type 2 diabetes.
Hazard Ratio: 1.27 (95% CI 1.24–1.3)
Introduction and Objective: Youth-onset type 2 diabetes (T2D) is associated with an aggressive disease course and high burden of microvascular complications. The objective of this analysis was to identify risk factors and develop a predictive parametric model for the occurrence of microvascular complications in youth-onset T2D. Methods: We used data from 677 participants in the TODAY clinical trial with long term follow-up data (median 6-year) for parametric modeling. The baseline characteristics and the clinical pharmacologic variables were assessed to determine the features affecting the risk of the microvascular complications (nephropathy, neuropathy, and retinopathy). Results: At baseline, risk of microvascular complications increased by 9.2% increase per 10 U/L ALT increase (95% CI, 1.07-1.11) and 27% increase per 1% HbA1c increase (95% CI, 1.24-1.30). Higher BMI and urine albumin to creatinine ratio at 6 months, higher systolic blood pressure and HbA1c change at 12 months also predicted a higher risk. The final parametric model provided accurate survival prediction consistent with the observed Kaplan-Meier curve by baseline risk groups (figure). Conclusion: The developed parametric model including baseline characteristics and clinical pharmacologic variables provides a foundational prediction tool and will be utilized within a digital twin framework of youth-onset T2D management. Disclosure S. Hwang: None. E. Yang: None. X. Luu: None. M.L. Tanenbaum: Speaker's Bureau; Current; Beta Bionics, Inc. Other - Honoraria; Ended; Sanofi. P. Phillips: None. S. Srinivasan: Research Support; Current; Abbott, Eli Lilly and Company. R. Savic: None. Funding American Diabetes Association (7-24-ICTST2DY-05)
HWANG et al. (Fri,) conducted a observational in youth-onset type 2 diabetes (n=677). Baseline HbA1c and ALT levels vs. Lower baseline levels was evaluated on microvascular complications (nephropathy, neuropathy, and retinopathy) (HR 1.27, 95% CI 1.24-1.30). In youth-onset type 2 diabetes, the risk of microvascular complications increased by 27% per 1% increase in baseline HbA1c (95% CI 1.24-1.30) and by 9.2% per 10 U/L increase in ALT.