GLP1R Rs3765467 Polymorphism Is Associated With The Risk Of Early-Onset Type 2 Diabetes

Objective: To investigate the relationship between glucagon-like peptide-1 receptor (GLP1R) gene polymorphisms and susceptibility to early-onset type 2 diabetes (EOD).Methods: Samples from 316 type 2 diabetes (T2DM) patients with EOD (n = 137) and late-onset T2DM (n = 179) and 145 non-diabetic individuals were analyzed. Multiplex PCR combined with resequencing HI-Reseq technology was used to detect single nucleotide polymorphisms (SNPs) of the GLP1R gene, and the allele frequency, genotype distribution, and clinical parameters were analyzed between each diabetes subgroup and the control group.Results: Sixteen SNPs were identified in the exonic region of the GLP1R gene according to the minor allele frequency (MAF > 0.05) in the participants. Among these, the GLP1R rs3765467 (G→A) mutation was statistically associated with EOD. Compared with that of the GG carriers, carriers of genotype AA at rs3765467 had a decreased risk of EOD after adjusting for sex and body mass index. In the dominant model, the frequencies of the rs3765467 AA+GA genotype were significantly decreased in the EOD group, and carriers of genotype AA+GA at rs3765467 had a decreased risk of EOD after adjusting for sex and body mass index. Moreover, fasting c peptide levels were significantly higher in GA+AA genotype carriers than that in GG genotype carriers.Conclusion: The GLP1R rs3765467 polymorphism was significantly associated with the age at T2DM diagnosis, and thus may be used as a marker to screen and detect individuals at risk of developing EOD.The name of the clinical trials registry: Exploration of early warning indicators for diabetic chronic complications. The approval number is 2016-004.The approval date is June 12, 2016.

Diabetes Distress in Young Adults with Youth-onset Type 2 Diabetes: TODAY2 Study Results

Objectives<b>:</b> To assess prevalence of high diabetes distress and associated factors in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY2) cohort of young adults with youth-onset type 2 diabetes. <p>Methods<b>:</b> Participants completed the Diabetes Distress Scale (DDS) at end-of-study visits. Factors examined for association with high distress were demographic (gender, race/ethnicity, age, education, income), medical (HbA1c, BMI, complications), psychological (depressive and anxiety symptoms), and social (number in household, have offspring, healthcare coverage, established with diabetes care provider). Univariate logistic regressions identified factors associated with high distress that were controlled for in multivariate logistic regressions.</p> <p><a>Results<b>:</b></a> Of 438 participants, 66% were female, mean age=26.8 years, 18% non-Hispanic white, 37% non-Hispanic Black, 38% Hispanic. High distress (DDS ≥2) was reported by 105 (24%) participants. Subscales identified 40% with high “Regimen Distress,” 29.7% with high “Emotional Burden.” <a>A greater percentage of those with high distress were female (p=0.002), diagnosed with hypertension (p=0.037) and retinopathy (p=0.005), insulin treated, had higher HbA1c, and moderate-to-severe depressive and anxiety symptoms (all p’s <0.001). </a>In multivariate analyses, female gender, HbA1c (p<0.001 for both), anxiety symptoms (p=0.036), and lack of healthcare coverage (p=0.019) were associated with high distress, controlling for potential confounders. Reporting moderate-to-severe depressive symptoms was associated with high regimen distress (p=0.018) and emotional burden (p<0.001); insulin treatment was associated with high emotional burden (p=0.027).</p> <p>Conclusion: Future research should identify modifiable factors associated with high diabetes distress in those with youth-onset type 2 diabetes that may inform distress interventions with this medically vulnerable group.</p>

Diabetes Distress in Young Adults With Youth-Onset Type 2 Diabetes: TODAY2 Study Results

OBJECTIVE To assess the prevalence of high diabetes distress and associated factors in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY2) study cohort of young adults with youth-onset type 2 diabetes. RESEARCH DESIGN AND METHODS Participants completed the Diabetes Distress Scale (DDS) at end-of-study visits. Factors examined for association with high distress were demographic (sex, race/ethnicity, age, education, income), medical (HbA1c, BMI, complications), psychological (depressive and anxiety symptoms), and social (number in household, offspring, health care coverage, established with diabetes care provider). Univariate logistic regression identified factors associated with high distress that were controlled for in multivariate logistic regressions. RESULTS Of 438 participants, 66% were female (mean age 26.8 years, 18% non-Hispanic White, 37% non-Hispanic Black, 38% Hispanic). High distress (DDS ≥2) was reported by 105 (24%) participants. Subscales identified 40% with high regimen distress and 29.7% with high emotional burden. A greater percentage of those with high distress were female (P = 0.002), diagnosed with hypertension (P = 0.037) and retinopathy (P = 0.005), treated with insulin, had higher HbA1c, and had moderate to severe depressive and anxiety symptoms (all P &lt; 0.001). In multivariate analyses, female sex (P &lt; 0.001), HbA1c (P &lt; 0.001), anxiety symptoms (P = 0.036), and lack of health care coverage (P = 0.019) were associated with high distress, after controlling for potential confounders. Moderate to severe depressive symptoms were associated with high regimen distress (P = 0.018) and emotional burden (P &lt; 0.001); insulin treatment was associated with high emotional burden (P = 0.027). CONCLUSIONS Future research should identify modifiable factors associated with high diabetes distress in young adults with youth-onset type 2 diabetes that may inform distress interventions with this medically vulnerable group.

Diabetes Distress in Young Adults with Youth-onset Type 2 Diabetes: TODAY2 Study Results

Objectives<b>:</b> To assess prevalence of high diabetes distress and associated factors in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY2) cohort of young adults with youth-onset type 2 diabetes. <p>Methods<b>:</b> Participants completed the Diabetes Distress Scale (DDS) at end-of-study visits. Factors examined for association with high distress were demographic (gender, race/ethnicity, age, education, income), medical (HbA1c, BMI, complications), psychological (depressive and anxiety symptoms), and social (number in household, have offspring, healthcare coverage, established with diabetes care provider). Univariate logistic regressions identified factors associated with high distress that were controlled for in multivariate logistic regressions.</p> <p><a>Results<b>:</b></a> Of 438 participants, 66% were female, mean age=26.8 years, 18% non-Hispanic white, 37% non-Hispanic Black, 38% Hispanic. High distress (DDS ≥2) was reported by 105 (24%) participants. Subscales identified 40% with high “Regimen Distress,” 29.7% with high “Emotional Burden.” <a>A greater percentage of those with high distress were female (p=0.002), diagnosed with hypertension (p=0.037) and retinopathy (p=0.005), insulin treated, had higher HbA1c, and moderate-to-severe depressive and anxiety symptoms (all p’s <0.001). </a>In multivariate analyses, female gender, HbA1c (p<0.001 for both), anxiety symptoms (p=0.036), and lack of healthcare coverage (p=0.019) were associated with high distress, controlling for potential confounders. Reporting moderate-to-severe depressive symptoms was associated with high regimen distress (p=0.018) and emotional burden (p<0.001); insulin treatment was associated with high emotional burden (p=0.027).</p> <p>Conclusion: Future research should identify modifiable factors associated with high diabetes distress in those with youth-onset type 2 diabetes that may inform distress interventions with this medically vulnerable group.</p>

Pregnancy Outcomes in Young Women With Youth-Onset Type 2 Diabetes Followed in the TODAY Study

<b>Objective:</b> To assess pregnancy outcomes in young women with youth-onset type 2 diabetes followed in the TODAY study. <p><em><b>Research Design and Methods:</b></em><em> </em>Pregnancy information (outcome, any maternal or fetal complications) was obtained from the female participants by self-report. Additionally, medical records for the pregnancy and the child’s neonatal course were obtained with data abstracted into standardized forms.<em></em></p> <p><b>Results:</b> Over a maximum of 15 years, 260 pregnancies were reported by 141 women (age 21.5 years ± 3.2 years, BMI 35.6 ± 7.2 kg/m², diabetes duration 8.1 ± 3.2 years). Contraception use prior to pregnancy reported by 13.5% of the women. Complications were reported by 65% of the women during their pregnancy. Pregnancy loss was observed in 25.3% and preterm birth in 32.6% of pregnancies. HbA1c ≥ 8% was observed in 31.9% of the pregnancies and 35% of the pregnancies were complicated by chronic hypertension. Nephropathy prior to pregnancy was observed in 25% of the women. In the offspring, 7.8% were classified as small for gestational age, 26.8% large for gestational age, and 17.9% in the macrosomic range.</p> <b>Conclusion:</b> Based on observations from the TODAY cohort, young women with pre-gestational, youth-onset type 2 diabetes had very high rates of maternal complications stemming from significant socioeconomic disadvantage. The substantial maternal and infant complications seen in these young moms could potentially be avoided with improved contraception rates and reproductive planning.