In youth-onset type 2 diabetes, glycemic variability was high and correlated with HbA1c, while insulin therapy was associated with higher glucose standard deviation (46 vs. 24 mg/dL, P<0.01).
Cohort (n=52)
Youth-onset type 2 diabetes is associated with high day-to-day glycemic variability, which correlates with HbA1c and is highest in patients on insulin therapy, highlighting a potential independent risk factor for cardiovascular disease.
Introduction and Objective: Free-living glycemic variability (GV), measured by continuous glucose monitors (CGM), is an independent risk factor for cardiovascular disease (CVD) in adults with diabetes, but GV data in youth-onset type 2 diabetes (Y-T2D) is scarce. To identify CVD risk factors in Y-T2D, we characterized GV in Y-T2D. Methods: This was a pooled cohort secondary analysis in Y-T2D enrolled in clinical trials between 2021-2025. GV within a day was measured by glucose standard deviation (SD) and GV between days was measured with mean of daily differences (MODD) using Dexcom CGM over 7-10 days. The relationship with contemporaneous HbA1c was assessed with Spearman’s correlation and linear regression, adjusted for age and BMI. Results: In 52 Y-T2D participants (age 17.0±4.4y, 33% male; 81% Black; 14% Hispanic/Latino; BMI 38.7±10.1 kg/m2, mean±SD), 10 were on basal insulin and 26 were on a glucagon-like peptide-1 receptor agonist. Median HbA1c was 6.3% (5.5, 7.6%) (25th, 75th percentile). Average CGM wear time was 8.7±1.6 days. SD and MODD were elevated at 27 (18, 41 mg/dL) and 25 (16, 37 mg/dL), respectfully. GV correlated with HbA1c and a 1% increase in HbA1c increased GV by ~3 mg/dL (Figure 1). Only insulin therapy was associated with higher HbA1c (10.8 vs. 6%, P0.01), SD (46 vs. 24 mg/dl, P0.01), and MODD (46 vs. 22 mg/dl, P0.01). Conclusion: GV was high in Y-T2D, implying increased risk for CVD beyond HbA1c. Future studies examining CVD risk in Y-T2D should consider both GV and HbA1c. Disclosure N. Rangos: None. I.N. Kacker: None. M.M. Gaydos: None. S.L. Cantor: None. N. Sala: None. N.A. Macheret: None. L. Mabundo: None. N. Malandrino: None. D.E. Estrada: None. S. Chung: None. Funding NIDDK, NIH Z99 DK 999999
Rangos et al. (Fri,) conducted a cohort in Youth-onset type 2 diabetes (n=52). Glycemic variability was evaluated on Glycemic variability (SD and MODD) and its relationship with HbA1c. In youth-onset type 2 diabetes, glycemic variability was high and correlated with HbA1c, while insulin therapy was associated with higher glucose standard deviation (46 vs. 24 mg/dL, P<0.01).
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