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Top stories in endocrinology: Type 2 diabetes more aggressive in adolescents, advancements in diabetes tech

The top stories in endocrinology include a number of updates from the American Diabetes Association annual meeting, including a report indicating adolescents with prediabetes or newly diagnosed type 2 diabetes have more aggressive disease and early treatment does not substantially limit its progression. Diabetes technology is intended to regulate blood glucose and reduce disease complication more effectively while simplifying management; however, cost, patient access and bulky technology that is not user-friendly have limited uptake and implementation. Other top stories include adults with type 2 diabetes assigned the SGLT2 inhibitor canagliflozin did not have an increased risk for below-the-knee amputation, contradicting previous findings; adults with type 1 diabetes concurrently wearing three continuous glucose monitor devices showed lower accuracy than reported in clinical devices, and data suggest that several maternal, childhood and familial factors play a role in islet autoimmunity risk.

RISE: Type 2 diabetes more aggressive in adolescents; early treatment unlikely to slow progression

Adolescents with prediabetes or newly diagnosed type 2 diabetes have much more aggressive disease than adults with similar glycemic profiles, and early treatment with insulin and metformin does not substantially slow its progression, according to data from three RISE studies. Read More.

In new era of diabetes tech, advancements poised to change management for type 1 and type 2

Technology for individuals with type 1 diabetes, such as insulin pumps, continuous glucose monitors and other “smart” devices, are intended to improve regulation of blood glucose and reduce disease complications, all while simplifying management of a complicated disease. Yet overall uptake of such devices has remained low due to a combination of barriers, including cost, patient access, and large or bulky technology that was not the most user-friendly. Read More.

OBSERVE-4D: No amputation risk with canagliflozin in type 2 diabetes

Adults with type 2 diabetes with and without established cardiovascular disease assigned the SGLT2 inhibitor canagliflozin did not have an increased risk for below-the-knee amputation compared with patients assigned similar SGLT2 inhibitors or other antidiabetes therapies, according to findings from the OBSERVE-4D study. These findings contradict those reported in the CANVAS trial. Read More.

Head-to-head comparison shows real-world accuracy differences among CGM devices

Among adults with type 1 diabetes concurrently wearing three continuous glucose monitoring devices, accuracy of the devices was lower than reported in clinical studies, according to a speaker at the American Diabetes Association annual meeting. Read More.

Insights from TEDDY study provide clues to islet autoimmunity in children

Data from the ongoing TEDDY study show that there are two diabetes-related endotypes defined by insulin autoantibodies or glutamic acid decarboxylase autoantibodies as the first appearing autoantibody in children, and ongoing research suggests several maternal, childhood and familial factors play a role in islet autoimmunity risk. Read More.