A recent research published in ‘Diabetes Care’ examined the effect of different patterns of durable glycemic control on the development of comorbidities among youth with type 2 diabetes (T2D) and assessed the impact of fasting glucose (FG) variability on the clinical course of T2D.

From the treatment options for T2D in adolescents and youth (TODAY) study, 457 participants (mean age, 14 years) with mean diabetes duration <2 years at entry and a minimum study follow-up of 10 years were included in the study. HbA1c, FG concentrations, and β-cell function estimates from oral glucose tolerance tests were measured longitudinally. The prevalence of comorbidities by glycemic control status after 10 years in the TODAY study was assessed.

The findings revealed that higher baseline HbA1c concentration, lower β-cell function, and maternal history of diabetes were strongly associated with loss of glycemic control in youth with T2D. A higher cumulative HbA1c concentration over 4 years and a greater FG variability over a year within 3 years of diagnosis were related to a higher prevalence of dyslipidemia, nephropathy, and retinopathy progression over the subsequent 10 years. A coefficient of variability in FG ≥8.3% predicted future loss of glycemic control and the development of co-morbidities.

The researchers concluded that higher baseline HbA1c concentration and FG variability during the first year accurately predicted youth with T2D who will experience metabolic decompensation and comorbidities.