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Retinopathy in youth with type 2 diabetes participating in the TODAY clinical trial.

ABSTRACT: To determine the prevalence of retinopathy in 517 youth with type 2 diabetes of 2-8 years duration enrolled in the TODAY study.Retinal photographs were graded centrally for retinopathy using established standards.Retinopathy was identified in 13.7% of subjects. Prevalence increased with age, diabetes duration, and mean HbA1c. Subjects in the highest BMI tertile had the lowest prevalence of retinopathy.Prevalence of retinopathy and its association with HbA1c and diabetes duration is similar to that previously reported in youth with type 1 diabetes and in adults with type 2 diabetes of known duration. The mechanism underlying the reduced risk of retinopathy in the most obese individuals is unknown. Follow-up of this cohort will help define the natural history of retinopathy in youth with type 2 diabetes.

SUBMITTER: TODAY Study Group

PROVIDER: S-EPMC3661825 | biostudies-literature | 2013 Jun

REPOSITORIES: biostudies-literature

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Retinopathy in youth with type 2 diabetes participating in the TODAY clinical trial.

Diabetes care 20130601 6

<h4>Objective</h4>To determine the prevalence of retinopathy in 517 youth with type 2 diabetes of 2-8 years duration enrolled in the TODAY study.<h4>Research design and methods</h4>Retinal photographs were graded centrally for retinopathy using established standards.<h4>Results</h4>Retinopathy was identified in 13.7% of subjects. Prevalence increased with age, diabetes duration, and mean HbA1c. Subjects in the highest BMI tertile had the lowest prevalence of retinopathy.<h4>Conclusions</h4>Preva ...[more]

PMID: 23704677

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Project description:Conducting longitudinal research related to chronic illness in adolescents is inherently challenging due to developmental changes and psychosocial stressors. Participants in the Treatment Options for type 2 Diabetes in Adolescents and Youth clinical trial were socioeconomically disadvantaged as well. This study assessed attitudes and beliefs about retention in Treatment Options for type 2 Diabetes in Adolescents and Youth to shed light on the factors that potentially promote and detract from the likelihood of sustained participation.After an average 7.3?years of follow-up (range 4.9-9.5), Treatment Options for type 2 Diabetes in Adolescents and Youth participants completed a survey examining their perceptions of the benefits and barriers to sustained involvement in the protocol.The most common reasons for staying in Treatment Options for type 2 Diabetes in Adolescents and Youth included having a strong relationship with the medical team, getting study-provided diabetes care, access to free diabetes medicine and supplies, and being part of a large study to learn more about how to care for youth-onset type 2 diabetes. The most commonly endorsed challenges included scheduling conflicts, possibly disappointing others, difficulties getting to study visits, and the occurrence of other medical issues.Similar to other published reports, a supportive relationship with study staff was commonly endorsed as a benefit of engagement in the longitudinal study, suggesting that rapport, staff consistency, and relationship quality are important components of optimal retention. Moreover, our findings suggest the value of trying to remove logistical barriers, such as transportation and scheduling challenges, in order to promote long-term participation in research. Further research is recommended to evaluate factors that contribute to attrition versus retention in an a priori manner within longitudinal studies, especially protocols involving cohorts that are more vulnerable to attrition due to developmental transitions and/or socioeconomic challenges. Additional efforts to optimize quantitative and qualitative measurement of barriers would also help to expand our understanding of how to optimally retain participants in longitudinal protocols.

Dataset Information

Retinopathy in youth with type 2 diabetes participating in the TODAY clinical trial.

Publications

Retinopathy in youth with type 2 diabetes participating in the TODAY clinical trial.

Similar Datasets

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