“TODAY” Reflects on the Changing “Faces” of Type 2 Diabetes

Abstract

The diabetes landscape has seen unprecedented changes over the recent past. On the one hand, there have been consistent and impressive advancements in clinical care, which include new therapeutic agents, novel dietary approaches, technical advances in glycemic monitoring and closed-loop technology, and a heightened awareness of individuals at risk. The tools required to treat and halt the progression of diabetes complications and the clinical evidence in support of effective management strategies have been established. On the other hand, the need for these developments has never been greater given the global burden of the diabetes epidemic. A particularly disturbing observation is that the “faces” of those who develop type 2 diabetes are becoming younger by the year as evidenced by the reports demonstrating the increased frequency of both type 1 and type 2 diabetes in youth (1–3). Until recent data were made available, it was really not known how adolescents would respond to therapies normally reserved for the adult population. We also had no evidence regarding the rate and severity of the complications in this age-group or the prevalence and progression of other risk factors. In this regard, the TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) study has succeeded in filling a major gap in knowledge (4–10). Thus, given the importance of the problem of type 2 diabetes in youth and the need to effectively disseminate the information, our editorial team has elected to feature the TODAY study in this issue of Diabetes Care . Specifically, articles from the TODAY study researchers featured in this issue provide new data on the efficacy and safety of clinical treatment and longitudinal observations of specific risk factors and complications for the new “faces” of the type 2 diabetes epidemic—namely, adolescents! As I reflect on the problem …