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June 7, 2026Diabetes

1136-OR: Longitudinal Time-to-Event Modeling and Identification of Risk Factors for the Occurrence of Microvascular Complications in Youth-Onset Type 2 Diabetes

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Why the study?

Youth-onset T2D is linked to an aggressive course and high microvascular complication burden, warranting risk factor identification and predictive parametric modeling.

Population

677 participants with youth-onset T2D in the TODAY clinical trial

Comparison

Risk factors including baseline characteristics and clinical pharmacologic variables

Design

Parametric longitudinal time-to-event modeling analysis of clinical trial follow-up data

Follow-up

Median 6-year

Key result

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.

Authors

SHSEJUNG HWANGEYEunsol YangXLXing Luu

Discussion

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Overview

May inform risk stratification in youth-onset T2D; hypothesis-generating and requires prospective validation before practice change.

Key Points

  • This analysis aims to identify risk factors and develop a predictive model for microvascular complications in youth-onset type 2 diabetes.
  • Analyzed data from 677 participants in the TODAY clinical trial with median 6-year follow-up.
  • Assessed baseline characteristics and clinical pharmacologic variables affecting microvascular complications.
  • Developed a parametric model for survival prediction using these risk factors.
  • 9.2% increase in risk of microvascular complications per 10 U/L increase in ALT (95% CI, 1.07-1.11).
  • 27% increase in risk per 1% increase in HbA1c (95% CI, 1.24-1.30).
  • Higher BMI, urine albumin to creatinine ratio, systolic blood pressure, and HbA1c changes at follow-up predicted increased risk.

Study Design

Type

Observational (n=677)

Structured PICO

P
Population
677 participants with youth-onset type 2 diabetes from the TODAY clinical trial, followed for a median of 6 years.
O
Outcome
Occurrence of microvascular complications (nephropathy, neuropathy, and retinopathy)composite

Main Result

Hazard Ratio: 1.27 (95% CI 1.24–1.3)

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.

Cite This Study

HWANG et al. (2026) conducted an 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.

synapsesocial.com/papers/6a250cbc7def13d035e1cf17https://doi.org/10.2337/db26-1136-or
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