Diabetes最新文献

{"title":"2094-P: The Effects of Glucagon-Like Peptide 1 Receptor Agonists on Body Composition in Youth-Onset Type 2 Diabetes: Six-Month Outcomes","authors":"LISA R. SCHAAF, REBEKAH A. TRACY, ANNA SCHUELER, HAILEY EISENMANN, SHENA RUSK, MARY SUSAN SEWELL, AMY SHAH","doi":"10.2337/db26-2094-p","DOIUrl":"https://doi.org/10.2337/db26-2094-p","url":null,"abstract":"Introduction and Objective: Glucagon like peptide-1 receptor agonist (GLP-1 RA) therapy used for treatment of youth-onset type 2 diabetes (T2D) is relatively new. Emerging data suggests weight loss with GLP-1 RA may not be attributed solely to fat loss, but also potential skeletal muscle mass loss, a potentially adverse metabolic outcome. Our study aimed to analyze body composition in youth with T2D who started GLP-1 RA therapy. Methods: We used InBody 270 scans to measure skeletal muscle mass (SMM, kg), skeletal muscle mass percentage (SMM%, %), body fat mass (BFM, kg), and body fat mass percentage (BFM%, %) pre (n=23) and 6-months post (n=14) initiation of GLP-1 RA medication. Paired t-tests were used to assess changes where complete pairs existed (n=14). Results: At baseline, youth with T2D were 47.8% Black/African American, 43.5% white and 95.7% non-Hispanic, had a mean (SD) age of 17. 0 (3.3) years and BMI of 40.1 (7.5) kg/m2. Over 6 months HbA1c improved significantly, 7.3 (1.5) to 6.7 (1.1)%, p=0.02 and BMI z-score increased slightly 2.57 (0.57) to 2.74 (0.71), p=0.86. There was no significant loss of SMM (change of -0.12(1.90), p=0.81), SMM% (change of +0.23 (1.27), p=0.52), but also no significant changes in BFM (change of -0.89 (5.07), p=0.52) or BFM% (change of -0.41(2.10), p=0.48). Interestingly, when n=3 youth on tirzepatide were compared to n=11 on dulaglutide, those on tirzepatide lost BFM (change of -3.40 (2.84)) and BFM% (change of -1.13 (1.03)), while maintaining SMM% (change of +0.57 (1.13)) as compared to youth on dulaglutide who gained BFM (change of +0.98 (3.39)) and BFM% (change of +0.25 (1.98)) and experienced mild SMM% loss (change of -0.10 (1.17)). Conclusion: Preliminary analyses of 6-month GLP-1 RA use in youth with T2D shows no significant changes in body composition. Initial analysis may suggest beneficial effects of tirzepatide though sample size is limited. Ongoing data collection and 12-month study data will evaluate the influence of behavioral (exercise and eating) habits and metabolic markers (lipids, liver enzymes). Disclosure L.R. Schaaf: Advisory Panel; Ended; Novo Nordisk. R.A. Tracy: None. A. Schueler: None. H. Eisenmann: None. S. Rusk: None. M. Sewell: None. A. Shah: Consultant; Ended; AbbVie Inc. Funding Cincinnati Children's Carolyn Stoll Nursing Research Grant","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"55 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2118-P: Teplizumab Treatment Induces a Transient Increase in Pancreas Size in Individuals with Type 1 Diabetes (T1D)","authors":"JACK VIROSTKO, JORDAN WRIGHT, JON WILLIAMS, DEMETRA BRAUN, MELISSA A. HILMES, SIRI ATMA W. GREELEY, ALVIN C. POWERS, DANIEL J. MOORE","doi":"10.2337/db26-2118-p","DOIUrl":"https://doi.org/10.2337/db26-2118-p","url":null,"abstract":"Introduction and Objective: Pancreas size declines in individuals progressing from Stage 1/2 to Stage 3 T1D. Whether teplizumab treatment, which delays progression to Stage 3 T1D, affects pancreas size is not known. Methods: We performed longitudinal MRI using a standardized protocol at two sites (27 MRIs total) in ten individuals with Stage 2 T1D (mean age 16, range 9 - 64, 30% female) treated with teplizumab. Pancreas volume was quantified by a blinded reader and divided by body weight to yield pancreas volume index (PVI). Results: Individuals treated with teplizumab displayed a wide range of baseline PVI at infusion (0.37 ml/kg to 1.68 ml/kg). The mean baseline PVI was 0.85 ml/kg, similar to established PVI in Stage 1 and 2 T1D (PMID: 38151474). PVI transiently increased in individuals treated with teplizumab at ~six months post-infusion. In contrast, PVI was stable in individuals with Stage 1 or Stage 2 T1D not treated with Teplizumab (PMID: 38151474) who do not progress to Stage 3. Conclusion: These data suggest that teplizumab induces a transient increase in pancreas size six months post infusion which returns to baseline one year post infusion. Ongoing studies will determine how initial volume and dynamic changes correspond to treatment outcomes. Disclosure J. Virostko: None. J. Wright: None. J. Williams: None. D. Braun: None. M.A. Hilmes: None. S.W. Greeley: None. A.C. Powers: None. D.J. Moore: Advisory Panel; Current; Sanofi-Aventis U.S. Funding Helmsley Charitable Trust (2201-05374)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"67 1 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2080-P: Differences in Transfer of Care in Type 1 and Type 2 Diabetes","authors":"NATALIE CONBOY, JIAFENG LI, ABIGAEL FINKLE, TATIANA MCINTYRE, SEAN DELACEY","doi":"10.2337/db26-2080-p","DOIUrl":"https://doi.org/10.2337/db26-2080-p","url":null,"abstract":"Introduction and Objective: Young adults with diabetes face challenges transferring to adult care. Little is known about transfer in young adults with type 2 diabetes (YT2D). We hypothesized that YT2D would have lower rates of successful transfer than young adults with type 1 diabetes (YT1D). Methods: We conducted a retrospective review of transition-age patients (≥18 years old) with type 1 (N=636) or type 2 (N=305) diabetes treated over five years at a pediatric center. Groups were compared using Mann Whitney U tests or chi-square tests. Logistic regressions adjusted for covariates, used diabetes type as the predictor, and used successful transfer, loss to follow-up, and type of adult provider as outcomes. Successful transfer was defined as transfer <6 months after pediatric care; loss to follow-up was defined as no visit within 6 months and no scheduled appointment. Results: Compared to YT1D, YT2D were more often publicly insured (83.6% vs 41.7%), had lower HbA1c (6.4% vs 7.8%), and were less often non-Hispanic white (7.5% vs 56%) [p<0.001]. YT2D were frequently lost to follow-up (42.3%) and often transferred to a primary care provider (PCP) (45.6%). They had lower odds of successful transfer (OR: 0.55, CI: 0.3-0.98, p=0.043) and higher odds of PCP transfer (OR 8.97, CI: 3.85-22.3) p<0.001). Conclusion: Transition-age YT2D were frequently lost to follow-up and often saw a PCP for diabetes care. They were less likely than YT1D to successfully transfer to adult care. Disclosure N. Conboy: None. J. Li: None. A. Finkle: None. T. McIntyre: None. S. DeLacey: None. Funding Manne Research Institute Voucher Program; Medical-Dental Staff Lurie-Based Trainee Research grant","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"27 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2051-P: Diabetes Dietitians in Clinical Practice: Real-World Billing and Practice Data from the T1DX QI Collaborative","authors":"RACHEL J. FENSKE, EMMA L. OSPELT, DANIEL R. HIMSWORTH, GRACE FRANKLIN, REBECCA LANGER, WHITNEY N. BEATON, SIHAM ACCACHA, M. TRACY BEKX, ELIZABETH A. MANN","doi":"10.2337/db26-2051-p","DOIUrl":"https://doi.org/10.2337/db26-2051-p","url":null,"abstract":"Introduction and Objective: Clinical practice guidelines demonstrate the importance of dietitians providing routine care for people with diabetes. The implementation of these guidelines in practice can be challenging due to scheduling and billing practices. The primary objective of this work was to assess utilization of diabetes dietitians in clinical practice across adult and pediatric diabetes centers participating in the T1DX Quality Improvement (QI) Collaborative. Methods: An annual survey was administered from August-October 2025 to 64 centers participating in the T1DX-QI Collaborative. Descriptive analysis of reported data was completed. Results: Responses were collected from 63 of 64 centers (98%); 67% were pediatric centers and 33% were adult centers. For both pediatric and adult centers, 85% report billing for dietitian visits. Only 35% of pediatric centers, while 68% of adult centers, reported that the dietitians were required to be Certified Diabetes Care and Education Specialists. Dietitian visits were more likely to be combined with a provider visit for pediatric centers and 68% of pediatric centers reported that their patients had at least 1 dietitian visit per year (compared to 40% of adult centers). Conclusion: Professional billing for dietitian visits is a common practice across centers. Scheduling practices and credentialing requirements for diabetes dietitians vary across pediatric and adult centers participating in the T1DX-QI Collaborative. Disclosure R.J. Fenske: None. E.L. Ospelt: None. D.R. Himsworth: None. G. Franklin: None. R. Langer: None. W.N. Beaton: None. S. Accacha: None. M. Bekx: None. E.A. Mann: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"16 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2119-P: Racism as a Shared Psychosocial Stressor in Parent–Youth Dyads: Findings from the BEAD-T1D Study","authors":"ANANTA ADDALA, SARAH HANES, LAUREN FIGG, DANIEL GARFIAS SILVA, GARY M. SHAW, DIANA NARANJO, JENNIFER RAYMOND, DAVID MAAHS, KOREY HOOD","doi":"10.2337/db26-2119-p","DOIUrl":"https://doi.org/10.2337/db26-2119-p","url":null,"abstract":"Introduction and Objective: Social determinants of health, including racism and psychosocial stress, are increasingly recognized as drivers of diabetes-related outcomes. The BEAD-T1D study examined relationships in parent-youth dyads across three key domains: racism exposure, diabetes technology perceptions, and psychosocial health. Methods: Parents and youth aged 12-21 years with T1D completed validated age-appropriate surveys assessing perceived racism and adverse childhood experiences, diabetes technology acceptance and burden, and psychosocial outcomes including depression, diabetes distress, and global health. Pearson correlations were used to measure correlations within and across dyads. Results: Dyads (n=80: 50% Hispanic, 55% publicly insured) demonstrated significant within-dyad correlations on explicit racism (r=0.42, p<0.001), diabetes distress (r=0.24, p=0.034), global health (r=0.35, p=0.001), and depression (r=0.38, p=0.001). The figure presents correlation arrows between parents (♦) and youth (←) across the domains of racism exposure (purple), diabetes technology perceptions (green), and psychosocial health (blue). Conclusion: These findings demonstrate the interconnected nature of the health determinants within minoritized families. Racism exposure correlates with diabetes technology perception and psychosocial health, suggesting that racism is embedded into diabetes experience for minoritized dyads. Disclosure A. Addala: None. S. Hanes: None. L. Figg: None. D. Garfias Silva: None. G.M. Shaw: None. D. Naranjo: None. J. Raymond: None. D. Maahs: Advisory Panel; Current; Abbott Diabetes, Sanofi, Medtronic, biospex, enable biosciences, kriya. K. Hood: Consultant; Current; Sanofi, MannKind Corporation, Insulet Corporation. Funding NIDDK (5K23DK131342)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"69 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2112-P: Shared Gains, Stubborn Gaps: Continuous Glucose Monitor (CGM) Outcomes at Diabetes Camp","authors":"JODY GRUNDMAN, CHAITANYA SAMBANGI, NICOLE RANGOS, AMANDA PERKINS, RANDI STREISAND, SHIDEH MAJIDI, RACHEL LONGENDYKE","doi":"10.2337/db26-2112-p","DOIUrl":"https://doi.org/10.2337/db26-2112-p","url":null,"abstract":"Introduction and Objective: The effects of diabetes camps on glycemia and differences by race or socioeconomic status (SES) are not well defined. Methods: We reviewed CGM data for T1D youth attending a 1-week diabetes camp at 6 time points (14 days pre-camp, camp, and 14 days, 1 month, 2 months, and 3 months post-camp). Linear mixed-effects models assessed time effects and modification by race, insurance, and SDI. Results: Twenty-seven youth participated (median age 12.5y, 69% female, 54% NHW, 39% NHB, 8% Asian, 23% public insurance, median SDI 47, 89% AID use). During camp, TIR improved versus baseline (59% vs 55%, p=0.03), TAR>250 mg/dL decreased (17% vs 22%, p=0.01), and mean glucose decreased (175 mg/dL vs 185 mg/dL, p=0.02). Glycemia worsened at 14 days post-camp, with partial recovery by 1 month and stabilization through 2-3 months (TIR, TAR>250, and mean glucose all p<0.01), without increased hypoglycemia (TBR<70 mg/dL p>0.05). Disparities by race and SES were observed for TIR (race p=0.03, insurance p=0.01, SDI p=0.02), TAR>250 (race p=0.02, insurance p=0.02, SDI p=0.03), mean glucose (race p=0.02, insurance p=0.03, SDI p=0.04), and GMI (race p=0.03, insurance p=0.04, SDI p=0.03) (Fig 1). Significant time-by-race interactions were seen for TAR>180 (p<0.01) and GMI (p=0.04). Conclusion: Despite persistent disparities by race and SES, diabetes camp participation was associated with meaningful glycemic improvement in T1D youth, supporting camp as a potentially equitable intervention. Disclosure J. Grundman: Advisory Panel; Current; Sanofi. C. Sambangi: None. N. Rangos: None. A. Perkins: None. R. Streisand: None. S. Majidi: Advisory Panel; Current; Sanofi. R. Longendyke: Advisory Panel; Ended; Sanofi.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"35 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2064-P: Baseline Care Gaps and Glycemic Control among Rural New Mexico Patients with Diabetes and Multiple Comorbidities: Findings from the E4DMMC Trial","authors":"YILIANG ZHU, MATT BOUCHONVILLE, GRETCHEN M. RAY, VALLABH SHAH, BRANT HAGER","doi":"10.2337/db26-2064-p","DOIUrl":"https://doi.org/10.2337/db26-2064-p","url":null,"abstract":"Introduction and Objective: Diabetes mellitus with multiple comorbidities (DMMC) is highly prevalent in rural and racial/ethnic minority populations, where limited access to specialty care contributes to suboptimal outcomes. The ECHO for Diabetes Mellitus and Multiple Comorbidities (E4DMMC) study is a pragmatic, cluster-randomized trial evaluating whether a Project ECHO intervention for primary care teams improves care delivery and outcomes for DMCC patients in rural New Mexico. This analysis characterizes baseline healthcare utilization, processes, and glycemic outcomes to establish benchmarks for evaluating intervention effects. Methods: Demographics, comorbidities (including hypertension, hyperlipidemia, chronic kidney disease, and depression), and healthcare utilization were described and trend analyses conducted over an 18-month baseline to assess outpatient visits, lab monitoring, medication use, preventive care services, self-management counseling, and HbA1c trajectories. Results: Among 5,835 adults with diabetes and ≥2 comorbidities, the mean age was 64.3 years, 51% female, 75% Hispanic or members of racial/ethnic minority groups; 60% resided in rural areas; and 70% were insured through Medicare or Medicaid. Patients averaged 3.18 outpatient visits per person-year. For care processes, 32% received diabetes monitoring and 60% kidney disease monitoring. Foot and eye examinations were completed in 45% and 29% of patients, respectively. Preventive counseling was completed in 98% of patients for nutrition and physical activity, self-management education was completed in 62% for diabetes, 44% for hypertension, and 28% for tobacco cessation. Overall, 37% of patients had poor glycemic control (any HbA1c >9%). Conclusion: Gaps in ADA-recommended care processes and poor glycemic control underscore the need for scalable care-delivery models for complex diabetes management in underserved settings and provide a critical reference for evaluating the E4DMMC trial. Disclosure Y. Zhu: None. M. Bouchonville: None. G.M. Ray: None. V. Shah: None. B. Hager: None. Funding PCORI TE-2022C3-30560","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"6 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2038-P: Provider Barriers and Enablers for Initiating Technologies among Socially Disadvantaged Adults with Type 1 Diabetes: A Qualitative Study in Ontario and Québec","authors":"JOYEUSE SENGA, PATIENCE FAKEMBE, ALEGRIA BENZAQUEN, XI M. ZHU, WAJEEHA CHEEMA, CHRISTINE E. MACGIBBON, RAYZEL SHULMAN, LORRAINE LIPSCOMBE, MERANDA NAKHLA, MAMAN JOYCE DOGBA, LEIF ERIK LOVBLOM, ANNE-SOPHIE BRAZEAU, HOLLY WITTEMAN, JUSTIN PRESSEAU, ALANNA WEISMAN","doi":"10.2337/db26-2038-p","DOIUrl":"https://doi.org/10.2337/db26-2038-p","url":null,"abstract":"Introduction and Objective: Lower uptake of diabetes technologies among socially disadvantaged adults with type 1 diabetes (T1D) may be partly driven by provider-level barriers. This study examined barriers and enablers influencing providers’ initiation of continuous glucose monitoring (CGM), insulin pumps, and automated insulin delivery (AID). Methods: We conducted twenty-nine semi-structured interviews in English and French with purposively sampled endocrinologists (n = 16) and certified diabetes educators (CDEs; n = 13) in Ontario and Québec. Two analysts independently coded transcripts deductively using the Theoretical Domains Framework. Results: Data saturation was achieved across interviews with endocrinologists and CDEs. Endocrinologists reported barriers including lack of standardized initiation workflows, limited technical involvement in pump initiation, and lower confidence initiating pumps compared with CGM, driven by safety and socioeconomic concerns. Facilitators included positive clinical feedback, interprofessional collaboration, and viewing AID as standard of care. CDEs reported greater confidence initiating pumps but experienced cognitive and emotional overload when supporting socially disadvantaged patients. Facilitators included active roles in pump training, frequent technology discussions, and standardized processes. Cross-cutting themes included gatekeeping driven by perceived socioeconomic constraints, limited access to tailored or translated education materials, challenges navigating coverage and social supports, and provider advocacy beyond clinical roles. Conclusion: Provider role, confidence, and system-level constraints shape technology initiation for socially disadvantaged adults with T1D. Interventions addressing workflows, team roles, education resources, and policy navigation may reduce inequities in technology uptake. Disclosure J. Senga: None. P. Fakembe: None. A. Benzaquen: None. X.M. Zhu: None. W. Cheema: None. C.E. MacGibbon: None. R. Shulman: None. L. Lipscombe: None. M. Nakhla: None. M. Dogba: None. L. Lovblom: None. A. Brazeau: Research Support; Current; Canadian Institutes of Health Research, Société Francophone du Diabète, Diabète Québec. Research Support; Ended; Mitacs. Speaker's Bureau; Ended; dexcom canada. H. Witteman: None. J. Presseau: None. A. Weisman: None. Funding Diabetes Canada End Diabetes Award, Canadian Institutes of Health Research (CIHR), Breakthrough T1D Canada","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"147 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2917-LB: Prescribing Practices and Clinical Support for GLP-1 Receptor Agonists in Youth-Onset Type 2 Diabetes: Data from the T1DX QI Collaborative","authors":"YASHODA NAIK, RACHEL J. FENSKE, DHRUVI VORA, MONICA BIANCO, TAMARA S. HANNON, CINTYA SCHWEISBERGER, SIHAM ACCACHA, MILI V. VAKHARIA, ORI ODUGBESAN, ELIZABETH A. MANN","doi":"10.2337/db26-2917-lb","DOIUrl":"https://doi.org/10.2337/db26-2917-lb","url":null,"abstract":"Introduction and Objective: The ADA recommends GLP-1 RAs in youth onset type 2 diabetes (YO-T2D) when glycemic targets are not met with metformin. We aimed to assess access to and usage of GLP-1 RAs in YO-T2D across pediatric diabetes centers within the T1D Exchange QI Collaborative (T1DX-QI). Methods: The 2025 T1DX-QI annual survey was administered to all member centers. Responses were collected from representatives at each center. Descriptive analyses summarized GLP-1 RA use, insurance coverage, access, and monitoring. Results: Among 42 responding pediatric centers 88% reported GLP-1 RA coverage for YO-T2D for privately insured and 81% for publicly insured patients. Estimated GLP-1 RA use varied widely with 25 centers reporting that ≤50% of patients with YO-T2D were prescribed GLP-1 RAs. Only 31% of centers reported having structured follow-up protocols with most centers relying on patients to schedule clinic visits instead of proactive outreach between appointments. Conclusion: Reports of insurance coverage for GLP-1 RAs in YO-T2D were variable based on insurance type and prescribing rates were low for several centers, suggesting opportunities to support prescribers and patients in accessing GLP-1 RAs. Disclosure Y. Naik: None. D. Vora: None. M. Bianco: None. T.S. Hannon: None. C. Schweisberger: None. S. Accacha: None. M.V. Vakharia: Consultant; Current; Dexcom, Inc. O. Odugbesan: None. Funding Leona M. and Harry B. Helmsley Charitable Trust","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"6 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2089-P: Hemoglobin A1c Trajectories from Diabetes Onset in Youth with Type 2 Diabetes (T2D)","authors":"ANNA KADI, DANIEL PALACIOS, SUKRU ARAS, LYDIA SOBHI, HU CHEN, ZHANDONG LIU, MARIA J. REDONDO, MUSTAFA TOSUR","doi":"10.2337/db26-2089-p","DOIUrl":"https://doi.org/10.2337/db26-2089-p","url":null,"abstract":"Introduction and Objective: Distinct A1c trajectories in youth with type 1 diabetes are associated with specific outcomes. Whether such trajectories exist in youth with T2D is unknown. We aimed to identify A1c trajectories after T2D onset in youth. Methods: Youth with T2D aged 8-20 years and diagnosed between 2011 and 2025 were identified from electronic medical records at a tertiary care center. Clustering analysis using A1c trajectory features (baseline, mean, slope, and change) identified patterns over 5 years after diagnosis. Demographic and clinical characteristics were compared across trajectories, and multivariable regression analyses identified predictors of diabetic complications. Results: The cohort included 2,449 youth (41.8% male, 58.3% Hispanic, 28.1% African American) with mean A1c at diagnosis of 8.7%. Three A1c trajectories were identified (Figure). Compared to the low A1c trajectory, the intermediate and high trajectories included higher proportions of African American and male youth (p<0.001, both). Youth in these trajectories were more likely to require insulin at 2 and 5 years after diagnosis (p<0.001, both). Belonging to the high A1c trajectory was among the strongest predictors of diabetic ketoacidosis. Conclusion: Distinct A1c trajectories occur after T2D onset in youth and are associated with demographic and clinical differences. Early identification of high-risk youth may help guide monitoring and targeted interventions. Disclosure A. Kadi: None. D. Palacios: None. S. Aras: None. L. Sobhi: None. H. Chen: None. Z. Liu: None. M.J. Redondo: Advisory Panel; Current; Sanofi. Other - Data Safety Monitoring committee; Current; Lilly. M. Tosur: None. Funding National Institutes of Health (3 U24 DK097771-12S1)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"16 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}