<b>OBJECTIVES: </b>To describe temporal
trends and correlates of glycemic control in youth and young adults (YYA) with
youth-onset diabetes.
<p><b>RESEARCH DESIGN AND METHODS: </b>The
study included 6,492 participants with type 1 or type 2 diabetes from the SEARCH
for Diabetes in Youth study. Participant visit data were categorized into time
periods 2002-2007, 2008-2013 and 2014-2019, diabetes durations of 1-4, 5-9, and
10+ years, and age groups 1-9, 10-14, 15-19, 20-24, 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 A<sub>1c</sub> (HbA<sub>1c</sub>) 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 duration and age group.</p>
<p><b>RESULTS: </b>Adjusted mean HbA<sub>1c</sub> 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 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 2014-2019 type 1 diabetes participants. Adjusted mean HbA1c was 8.6%±0.12%
for 2014-2019 YYA with type 2 diabetes. Participants
age 25+ 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 type 2 diabetes participants.</p>
<p><b>CONCLUSIONS: </b>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.</p>
<br>
Increase in Prevalence of Diabetic Ketoacidosis at Diagnosis Among Youth With Type 1 Diabetes: The SEARCH for Diabetes in Youth Study
