Higher rates of comorbidities in young people with type 2 diabetes than type 1 - Insulin Algorithms

There are significantly higher rates of comorbidities in youth with type 2 diabetes vs type 1 diabetes, with three out of four type 2 diabetics developing one or more comorbid conditions by age 21, compared to only one in three type 1 diabetics. The findings were published in the Journal of the American Medical Association.

Once known as adult-onset diabetes, type 2 diabetes is increasing among children and adolescents, with more than 5,000 new diagnoses every year in the United States alone. Analyzing national data on young people who had diabetes for approximately eight years, using a registry called SEARCH for Diabetes in Youth, a research team led by Dr. Dana Dabelea at the Colorado School of Public Health found that 72% of patients with type 2 diabetes had developed one or more diabetes-related complications by age 21. These complications included kidney disease, retinopathy (eye disease), peripheral neuropathy (nerve damage in the extremities), hardened arteries, and high blood pressure.


Odds of Comorbidities with Type 2 Diabetes vs Type 1 DiabetesOdds of Comorbidities with Type 2 Diabetes vs Type 1 DiabetesOdds of Comorbidities with Type 2 Diabetes vs Type 1 DiabetesOdds of Comorbidities with Type 2 Diabetes vs Type 1 DiabetesOdds of Comorbidities with Type 2 Diabetes vs Type 1 Diabetes
ComplicationType 2 diabetes, %Type 1 diabetes, %HR (95% CI)*P
Diabetic kidney disease19.95.82.58 (1.39-4.81)0.003
Retinopathy9.15.62.24 (1.11-4.50)0.02
Peripheral neuropathy17.78.52.52 (1.43-4.43)0.001
Arterial stiffness47.411.61.07 (0.63-1.84)0.80
Hypertension21.610.10.85 (0.50-1.45)0.55


Comorbid conditions are what make diabetes such a devastating and financially burdensome disease. The US spends $88 billion per year on preventable complications, among them cardiovascular disease, which causes premature death in approximately two-thirds of people with diabetes. Diabetes is the leading cause of kidney failure in the US and the leading cause of blindness among working-age adults worldwide. To reduce the risk of comorbidities, more patients should be started on insulin. According to the American Diabetes Association’s 2017 Standards of Care, “For patients with type 2 diabetes who are not achieving glycemic goals, insulin therapy should not be delayed,” and research published in BMC Endocrine Disorders found that patients who start insulin immediately after diagnosis show lower rates of all comorbid conditions. The question is, how can insulin therapy be mainstreamed when there are too few specialists to manage every patient’s regimen—only 1,000 board-certified endocrinologists to serve 6,000 hospitals and 29 million diabetics in the US, and an even larger gap in other countries? The answer, of course, is to make insulin therapy easy enough for any clinician to manage.

Insulin Algorithms software gives clinicians the ability to make well-reasoned dose adjustments in less than one minute, using algorithms that have been trusted for decades to help insulin-dependent patients reach glycemic targets. The algorithms were pioneered by Dr. Mayer B. Davidson, co-founder of the largest network of community-based clinics in the US, former president of the American Diabetes Association, and recipient of the American Diabetes Association’s 2016 Outstanding Physician-Clinician Award. Our solution

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