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TODAY2 Phase 2 Follow-up

Completed
Conditions
Type 2 Diabetes
Interventions
Other: TODAY cohort
Registration Number
NCT02310724
Lead Sponsor
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Brief Summary

The primary objective of T2P2 is to track the progression of T2D and related comorbidities and complications in the TODAY cohort as they transition to young adulthood. We hypothesize that:

* Youth-onset type 2 diabetes (T2D) will progress rapidly and result in high rates of diabetes-related medical complications and comorbidities.

* The rapid rate of progression is related to increased insulin resistance characteristic of puberty, worse β-cell function, degree of glycemic control, control of non-glycemic factors, and obesity itself.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
517
Inclusion Criteria
  • Participated in TODAY clinical trial.
Exclusion Criteria

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
TODAY cohortTODAY cohortAll subjects randomized to the TODAY clinical trial are eligible to participate in T2P2. The study performs long-term observation only and administers no treatment, care, or management.
Primary Outcome Measures
NameTimeMethod
diabetic retinopathyyear 4

a microvascular complication determined by fundus photography

peripheral diabetic neuropathyevery 12 months

a microvascular complication defined as the presence of Michigan Neuropathy Screening Instrument (MNSI) exam score \>2 and \<8 out of 10 appropriate responses to the Semmes-Weinstein monofilament (SW-MF) in either foot.

arterial stiffnessyear 5

a macrovascular (cardiovascular) risk indicator determined by pulse wave velocity

overt diabetic nephropathyevery 12 months

a microvascular complication determined by glomerular filtration rate \< 70 mL/min/1.73m2

cardiac functionyear 2

a macrovascular (cardiovascular) risk indicator determined by echocardiogram

microalbuminuriaevery 12 months

a microvascular complication determined by urine albumin excretion \>= 30 mg/day

cardiovascular risk lipid valuesevery 12 months

a macrovascular (cardiovascular) risk indicator determined by abnormal lipid value for LDL (\>= 130 mg/dL) or triglycerides (\>= 300 mg/dL)

Secondary Outcome Measures
NameTimeMethod
glycemic controlevery 12 months

determined by HbA1c (annual)

blood pressureevery 12 months

determined by collection of blood pressure

sleep functionyears 2-3

determined by scores on standard questionnaires and in-lab polysomnogram

body compositionevery 12 months

determined by body mass index (BMI) computed from physical measurements of height and weight

eating disorderevery 12 months

determined by score on participant self report questionnaire Eating Disorder Diagnostic Scale (EDDS)

health-related quality of lifeevery 12 months

determined by score on the participant self report questionnaire Pediatric Quality of Life Inventory version 4.0 with age-specific versions for teen (13-18), young adult (19-25), and adult (≥26)

insulin sensitivity and beta cell functionparticipant years 6 and 9 from baseline

determined by oral glucose tolerance test (at 6 and 9 years from randomization) to derive measures of insulin sensitivity (1/insulin0), insulin secretion (ΔC-peptide30-0/Δglucose30-0, Δinsulin30-0/Δglucose30-0 if not on insulin), and the oral disposition index (oDI = insulin sensitivity x insulin secretion)

healthcare usageevery 6 months

determined by participant self report about visits, referrals, treatments, tests, and procedures related to healthcare

psychological disorderevery 12 months

determined by scores on the following participant self-report standard surveys: (a) the Beck Depression Inventory II (BDI-II), (b) the Patient Health Questionnaire (PHQ) scales for somatic symptoms, anxiety, and alcohol use; participants are also interviewed about emotional or mental health problems involving referral, treatment, or hospitalization, and psychiatric diagnoses made by a non-study source that can be confirmed according to standard study criteria from acquired medical records are also recorded

life stressevery 12 months

determined by participant self report questionnaire based on the Yeaworth Adolescent Life Change Event Scale

Trial Locations

Locations (15)

Yale University School of Medicine Department of Pediatrics

🇺🇸

New Haven, Connecticut, United States

Children's Hospital Los Angeles

🇺🇸

Los Angeles, California, United States

Children's Hospital of Pittsburgh

🇺🇸

Pittsburgh, Pennsylvania, United States

Washington University

🇺🇸

Saint Louis, Missouri, United States

Children's Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Columbia University Naomi Berrie Diabetes Center

🇺🇸

New York, New York, United States

Saint Louis University

🇺🇸

Saint Louis, Missouri, United States

SUNY Upstate New York University

🇺🇸

Syracuse, New York, United States

University of Colorado Denver Children's Hospital

🇺🇸

Aurora, Colorado, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Joslin Diabetes Center

🇺🇸

Boston, Massachusetts, United States

University of Oklahoma Health Science Center

🇺🇸

Oklahoma City, Oklahoma, United States

Baylor College of Medicine

🇺🇸

Houston, Texas, United States

Case Western Reserve University Rainbow Babies and Children's Hospital

🇺🇸

Cleveland, Ohio, United States

University of Texas Health Sciences Center

🇺🇸

San Antonio, Texas, United States

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