MON-218 - Early Glycemic Recovery in Youth with New Onset Type 2 Diabetes and Severe Hyperglycemia

Background: Type 2 diabetes mellitus (T2DM) is a disease of growing significance and global concern. In adolescence, the clinical course of T2DM is highly variable and may include glycemic recovery with insulin independence. Although several studies have reported the incidence of glycemic recovery and remission in adults, this has not been adequately explored in youth -onset T2DM.

Objective: To report the frequency of early glycemic recovery in youth with a new diagnosis of T2DM who presented with severe hyperglycemia, and to characterize the factors associated with this recovery.

Methods: This is a single center retrospective chart review of youth ages 9- 18 years with new onset T2DM with severe hyperglycemia (HbA1c ≥8.5%) requiring inpatient insulin management. The study cohort was comprised of 2 groups, recovery (R) and a non-recovery (NR) group. Glycemic recovery was defined as independence from an insulin requirement and was characterized by a HbA1c of < 7%. Comparisons between the 2 groups were determined by Kruskal Wallis test.

Results: The study included 103 youths with T2DM, mean age of diagnosis 14.1±1.8 years, and 50% male. 41% of the cohort were Black and 36% White. At diagnosis, BMI z score was 2.35 ± 0.68, HbA1c, 11.9% ± 1.8% and C- peptide 2.67 ± 1.3 ng/mL. Recovery was noted in in 17% of the total cohort and 50 % of those were males. There was no significant difference between the study groups regarding the age of diagnosis, baseline BMI z score, HbA1c, and C-peptide levels. Similarly, there was also no difference between the groups regarding initial total daily insulin dose and triglyceride levels.

Conclusion:
The rate of glycemic recovery within 2 years of youth onset T2DM diagnosis associated with severe hyperglycemia is considerable, 17% in this cohort. In addition, there was no difference between the study groups in clinical measures known to be associated with insulin resistance. This study highlights a potential unique window after diagnosis during which beta cell function may improve. Further studies are needed to uncover other factors which could predict the clinical course within the first 2 years of youth onset T2DM diagnosis.

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