P-27: Treatment patterns and metabolic outcomes in youth-onset type 2 diabetes
A Lacquaniti, L Gaete, M Balderrama, M Veizaga, C Puma, E Escudero, F Miari, C Araujo, P Palenque, A RoussosAbstract
Introduction
Type 2 diabetes (T2D) in youth has increased alongside obesity and shows a more aggressive course than in adults. Data on early evolution and treatment patterns in Latin America are limited.
Objectives
To describe treatment patterns, metabolic outcomes, and follow-up discontinuation in youth with T2D.
Methods
Retrospective cohort study at a pediatric hospital in Buenos Aires, Argentina. Patients <18 years diagnosed with T2D (2022–2025) were analyzed at diagnosis and last follow-up. Loss to follow-up was defined as absence of visits >6 months.
Results
Twenty-five patients (60% female). Presentation: hyperglycemia 48%, impaired glucose tolerance 28%, ketosis 12%, diabetic ketoacidosis 12%. HbA1c decreased from 9.3±3.3% to 6.1±0.4% (p<0.05); 77% (17/22) achieved <6.5%. Non-HDL cholesterol decreased (p<0.05); no changes in C-peptide or anthropometry. Metformin was started early (median 0 days, IQR 0–10); in those requiring insulin, initiation of metformin was delayed (10 days, IQR 2–34). Among those starting metformin (n=14), 71% remained on monotherapy; 3 required intensification (insulin, DPP-4 or SGLT2 inhibitors). Of those starting insulin (n=11), 7 discontinued and continued on metformin; 3 required ongoing insulin; time to discontinuation was 30 days (IQR 25–120). Median follow-up was 1.77 years (IQR 1.33–2.50). Fifteen remain in active care, 7 no visits in last 6 months, 3 discontinued within 1 year.
Conclusions
Youth-onset T2D showed significant metabolic improvement without decline in insulin reserve in this short period of follow-up, with heterogeneous treatment patterns. While many achieved treatment simplification, a subgroup required persistent insulin. Early detection and strategies to improve adherence are essential to reduce long-term risk.