The prevalence of type 2 diabetes in young people aged 10 to 19 has more than doubled in the past two decades, posing challenges for healthcare providers in predicting disease progression and treatment outcomes. A recent investigation suggests that assessing the levels of circulating microRNAs, which impact beta cells in the pancreas responsible for insulin production, may be just as reliable as traditional blood sugar measurements in determining the prognosis of young individuals with the condition.
The study, led by Dr. Jeanie Tryggestad, a pediatric associate professor at the University of Oklahoma College of Medicine, published in The Journal of Clinical Endocrinology & Metabolism, delved into the role of microRNAs in predicting the advancement of type 2 diabetes in youth, shedding light on their involvement in insulin resistance and other pathways that can jeopardize beta cell function. Understanding these mechanisms is crucial for developing preventive strategies.
“Children and adolescents with type 2 diabetes face a more aggressive disease course, particularly in terms of beta cell function decline compared to adults,” explained Tryggestad. “Identifying the triggers for beta cell dysfunction and intervening early is key to managing and preventing type 2 diabetes.”
The research revealed that baseline microRNA levels were nearly as effective as A1C measurements in foreseeing treatment failure in type 2 diabetes cases among youth. Treatment failure was defined as having an A1C exceeding 8% for six months, or requiring a return to insulin therapy without subsequent discontinuation. Circulating microRNAs also anticipated a 20% reduction in beta cell function within the initial six months of the study.
Although microRNA assessment is presently limited to research settings, Tryggestad highlighted the potential for clinical applications in the future. The study’s findings not only underscore the predictive value of microRNAs but also offer insights into the pathophysiology underlying the development and progression of type 2 diabetes.
“While blood sugar indicators are crucial in clinical practice, understanding microRNAs provides a deeper insight into disease mechanisms necessary for preventive strategies,” noted Tryggestad.
The escalating rates of type 2 diabetes in children demand urgent attention. In the United States alone, youth type 2 diabetes cases are rising by 5.3% annually, with projections indicating a staggering 700% increase by 2060. Presently, more teenagers aged 15 to 19 are living with type 2 diabetes than type 1 diabetes, a notable shift in disease burden.
The study analyzed samples from participants in the landmark TODAY study (Treatment Options for Type 2 Diabetes in Adolescents and Youth), where the OU College of Medicine played a pivotal role. The multicenter clinical trial, spanning from 2003 to 2020 and enrolling 699 participants, showcased Oklahoma’s significant contribution to the research.
Although the TODAY trial was instrumental in comparing treatment options for youth with type 2 diabetes, subsequent analyses, such as the examination of microRNA samples obtained over the study’s initial decade, continue to provide valuable insights into the condition’s complexities.
