AIMS/INTRODUCTION: The global incidence of adolescents with type 2 diabetes mellitus (T2DM) is increasing. We conducted this cohort study aiming to describe the characteristics, drug-use condition, and long-term outcomes of adolescents with T2DM. MATERIALS AND METHODS: 2755 newly diagnosed adolescents with T2DM (using ICD-9-CM: 250.x and having ≧3 clinic visits) were identified from the national health insurance dataset during 2000-2014. We classified treatments into 4 groups: metformin, sulfonylurea (SU), metformin plus SU, and insulin with or without oral antidiabetic drugs. Multiple Cox regression model was used to compare the risks of mortality and hospitalization among these 4 groups. RESULTS: The mean follow-up period was 5.4 years. After 1 year of antidiabetic treatment, they gradually needed intensified therapy, and at 3 years, half of them showed treatment failure. The mortality rate was 2.08 per 1000 person-years. Respiratory diseases (36.2%) and dysglycemia (16.4%) were the most common causes of hospitalization among these adolescents. Compared with persons taking metformin plus SU, metformin users were associated with a lower risk of all-cause hospitalization [0.82 (0.67-0.99)]; insulin users were associated with a higher risk of dysglycemia [4.38 (2.14-8.96)], cancer [3.76 (1.39-10.1)], and respiratory hospitalization [1.66 (1.14-2.41)]; and SU users were associated with a higher risk of hospitalization for respiratory diseases [1.91 (1.13-3.23)]. CONCLUSIONS: This nationwide cohort study demonstrated that adolescents with T2DM were prone to treatment failure. Furthermore, respiratory diseases and dysglycemia were the most common causes of hospitalization.
Date:
2022-11
Relation:
Journal of Diabetes Investigation. 2022 Nov;13(11):1905-1913.
