{"doi":"10.2337/dc23-0560","title":"Effect of Early Glycemic Control in Youth-Onset Type 2 Diabetes on Longer-Term Glycemic Control and β-Cell Function: Results From the TODAY Study","abstract":"OBJECTIVE: Little is known about the impact of early attainment of tight glycemic control on long-term β-cell function and glycemic control in youth-onset type 2 diabetes. We examined the effect of the initial 6 months of glycemic control on β-cell function and glycemic control longitudinally over 9 years and the impact of sex, race/ethnicity, and BMI on these relationships in adolescents with youth-onset type 2 diabetes in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. RESEARCH DESIGN AND METHODS: Oral glucose tolerance tests were performed longitudinally through year 9 to derive estimates of insulin sensitivity and secretion. Early glycemia was defined by mean HbA1c during the first 6 months postrandomization, categorized into five HbA1c groups (<5.7%, 5.7 to <6.4%, 6.4 to <7.0%, 7.0 to <8.0%, and ≥8.0%). The long-term period was defined as the period between years 2 and 9. RESULTS: A total of 656 participants (64.8% female, baseline mean age 14 years, diabetes duration <2 years) had longitudinal data available over an average of 6.4 ± 3.2 years of follow-up. HbA1c significantly increased in all early glycemic groups during years 2-9, with a steeper increase (+0.40%/year) among participants with the tightest initial control (mean early HbA1c <5.7%), in parallel to a decline in the C-peptide-derived disposition index. Nevertheless, the lower HbA1c categories continued to have relatively lower HbA1c over time. CONCLUSIONS: Early tight glycemic control in the TODAY study was related to β-cell reserve and translated to better long-term glycemic control. However, tight early glycemic control on the randomized treatment in the TODAY study did not prevent deterioration of β-cell function.","journal":"Diabetes Care","year":2023,"id":362416,"datarank":0.3969457230370843,"base_score":2.1972245773362196,"endowment":2.1972245773362196,"self_citation_contribution":0.32958368660043297,"citation_network_contribution":0.06736203643665135,"self_endowment_contribution":0.32958368660043297,"citer_contribution":0.06736203643665135,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":6,"citers_with_citation_signal":3,"citers_with_endowment":3,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9618,"is_data_producer":true,"deposit_databanks":{"figshare":["10.2337/figshare.22892528"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":7391,"name":"Kristen J. Nadeau","orcid":"0000-0002-0477-3356","position":1,"is_corresponding":false},{"id":524295,"name":"Laure El ghormli","orcid":"0000-0003-4223-8407","position":2,"is_corresponding":false},{"id":448934,"name":"Silva Arslanian","orcid":"0000-0002-1528-9324","position":3,"is_corresponding":false},{"id":431893,"name":"Fida Bacha","orcid":"0000-0002-9942-1889","position":4,"is_corresponding":false},{"id":262979,"name":"Sonia Caprio","orcid":"0000-0002-7523-5053","position":5,"is_corresponding":false},{"id":436470,"name":"Christine L. Chan","orcid":"0000-0003-3067-7672","position":6,"is_corresponding":false},{"id":659769,"name":"Lily C. Chao","orcid":"0000-0002-6294-0589","position":7,"is_corresponding":false},{"id":875365,"name":"Maria Rayas","orcid":"0000-0001-8658-7831","position":8,"is_corresponding":false},{"id":372871,"name":"Maggie Siska","orcid":null,"position":9,"is_corresponding":false},{"id":334625,"name":"Philip Zeitler","orcid":"0000-0001-5756-7858","position":10,"is_corresponding":false},{"id":888919,"name":"TODAY Study Group","orcid":null,"position":0,"is_corresponding":true}],"reference_count":23,"raw_metadata":null,"created_at":"2026-07-19T01:14:19.266946Z","pmid":"37378967","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}