In this follow-up study to the TODAY clinical trial, T2P2 will evaluate the rates of comorbidities and complications in the TODAY cohort and will compare with rates for children with type 1 diabetes with a similar age of onset and with adult-onset type 2 diabetes. Two hypotheses will be tested: (1) youth-onset T2D will progress rapidly and result in high rates of diabetes-related medical complications and comorbidities and (2) the rapid rate of progression is related to increased insulin resistance characteristic of puberty, worse β-cell function, degree of glycemic control, control of non-glycemic factors, and obesity itself.
TODAY Study Group. Treatment options for type 2 diabetes in adolescents and youth: a study of the comparative efficacy of metformin alone or in combination with rosiglitazone or lifestyle intervention in adolescents with type 2 diabetes. Pediatric Diabetes 2007; 8:74-87. PMC2752327
TODAY Study Group. A clinical trial to maintain glycemic control in youth with type 2 diabetes. NEJM 2012; 366:2247-2256. PMC3478667
Gandica R and Zeitler P. Update on youth-onset type 2 diabetes: lessons learned from the Treatment Options for Type 2 Diabetes in Adolescents and Youth clinical trial. Advances in Pediatrics 2016; 63:195-209. PMC4955876
Zeitler P, Hirst K, Copeland KC, El ghormli L, Katz LL, Levitsky LL, Linder B, McGuigan P, White NH, Wilfley D for the TODAY Study Group. HbA1c after a short period of monotherapy with metformin identifies durable glycemic control among adolescents with type 2 diabetes. Diabetes Care 2015; 38:2285–2292. PMC4657618
Klingensmith GJ, Pyle L, Nadeau KJ, Barbour LA, Goland RS, Willi SM, Linder B, White NH for the TODAY Study Group. Pregnancy outcomes in youth with type 2 diabetes: the TODAY study experience. Diabetes Care 2016; 39:122-129. PMC4686849
TODAY2 is the long term follow-up of the youth from TODAY, to track the progression of type 2 diabetes (T2D) and related comorbidities and complications in the TODAY cohort as they transition to young adulthood.
TODAY found that metformin plus rosiglitazone was more effective than metformin alone with metformin plus lifestyle having an intermediate effect resulting in more aggressive treatment in clinical practice