Younger adults with T2D are underrepresented in clinical trials, suggesting management gap

  • Sargeant JA & al.
  • Diabetologia
  • 02.06.2020

  • von Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Management guidelines for early-onset adult (diagnosis age, 18-39 years) type 2 diabetes (T2D) are extrapolated predominantly from evidence in older individuals.
  • The National Health Service England’s Research Needs Assessment 2018 included “interventions in the under 40s with T2D.”

Why this matters

  • Early-onset adult T2D is increasingly prevalent and associated with poor long-term outcomes.
  • These individuals may benefit from more aggressive interventions to halt development of diabetes complications.

Study design

  • Review of study populations recruited to 37 cardiorenal outcomes trials, 28 trials from phase 3 programs of empagliflozin, liraglutide, and sitagliptin, and 25 prominent trials of diabetes self-management education and support (DSMES) or intensive lifestyle interventions.
  • Funding: UK National Institute of Health Research; others.

Key results

  • In 90 trials with 268,978 individuals, the overall mean age was 63 years.
  • Proportions of patients ages 18-39 years:
    • 0.97% in the 12 cardiorenal outcomes trials (n=56,518) that included individuals aged
    • 4.87% in the phase 3 drug trials (n=18,974).
    • 3.01% of 17 DSMES trials that included ages

Limitations

  • Overall, 29 trials excluded individuals age 
  • Working-age adults are more difficult to recruit for trials.