OBJECTIVE To describe temporal trends and correlates of glycemic control in youth and young adults (YYA) with youth-onset diabetes. RESEARCH DESIGN AND METHODS The study included 6,369 participants with type 1 or type 2 diabetes from the SEARCH for Diabetes in Youth study. Participant visit data were categorized into time periods of 2002–2007, 2008–2013, and 2014–2019, diabetes durations of 1–4, 5–9, and ≥10 years, and age groups of 1–9, 10–14, 15–19, 20–24, and ≥25 years. Participants contributed one randomly selected data point to each duration and age group per time period. Multivariable regression models were used to test differences in hemoglobin A1c (HbA1c) over time by diabetes type. Models were adjusted for site, age, sex, race/ethnicity, household income, health insurance status, insulin regimen, and diabetes duration, overall and stratified for each diabetes duration and age group. RESULTS Adjusted mean HbA1c for the 2014–2019 cohort of YYA with type 1 diabetes was 8.8 ± 0.04%. YYA with type 1 diabetes in the 10–14-, 15–19-, and 20–24-year-old age groups from the 2014–2019 cohort had worse glycemic control than the 2002–2007 cohort. Race/ethnicity, household income, and treatment regimen predicted differences in glycemic control in participants with type 1 diabetes from the 2014–2019 cohort. Adjusted mean HbA1c was 8.6 ± 0.12% for 2014–2019 YYA with type 2 diabetes. Participants aged ≥25 years with type 2 diabetes had worse glycemic control relative to the 2008–2013 cohort. Only treatment regimen was associated with differences in glycemic control in participants with type 2 diabetes. CONCLUSIONS Despite advances in diabetes technologies, medications, and dissemination of more aggressive glycemic targets, many current YYA are less likely to achieve desired glycemic control relative to earlier cohorts.

中文翻译：

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青少年和年轻糖尿病患者的血糖控制趋势：青少年糖尿病研究研究


目的 描述患有青年期糖尿病的青少年和青年人 (YYA) 血糖控制的时间趋势和相关性。研究设计和方法 该研究纳入了来自“青年糖尿病研究”研究的 6,369 名患有 1 型或 2 型糖尿病的参与者。参与者访问数据分为2002-2007年、2008-2013年和2014-2019年的时间段，糖尿病病程为1-4年、5-9年和≥10年，年龄组为1-9年、10-14岁、 15–19、20–24 和 ≥25 岁。参与者为每个时间段的每个持续时间和年龄组提供一个随机选择的数据点。使用多变量回归模型来测试不同糖尿病类型的糖化血红蛋白 (HbA1c) 随着时间的推移的差异。模型根据地点、年龄、性别、种族/民族、家庭收入、健康保险状况、胰岛素治疗方案和糖尿病病程进行调整，总体上对每个糖尿病病程和年龄组进行分层。结果 2014-2019 年 YYA 1 型糖尿病队列的调整后平均 HbA1c 为 8.8 ± 0.04%。 2014-2019 年队列中 10-14、15-19 和 20-24 岁年龄组中患有 1 型糖尿病的 YYA 的血糖控制比 2002-2007 年队列更差。种族/族裔、家庭收入和治疗方案预测了 2014-2019 年队列中 1 型糖尿病参与者的血糖控制差异。 2014-2019 年 2 型糖尿病患者的调整后平均 HbA1c 为 8.6 ± 0.12%。与 2008-2013 年队列相比，年龄≥25 岁的 2 型糖尿病参与者的血糖控制较差。只有治疗方案与 2 型糖尿病参与者的血糖控制差异相关。 结论 尽管糖尿病技术、药物治疗和更积极的血糖目标的传播取得了进步，但与早期队列相比，许多当前的 YYA 不太可能实现所需的血糖控制。