Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY)

The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study is a landmark National Institutes of Health study that monitors more than 700 children and adolescents with type 2 diabetes. The study takes place in multiple centers across the nation. It considers why diabetes is on the rise in children and how this links to obesity. UH Rainbow Babies & Children’s Hospital and Case Western Reserve University School of Medicine are among 15 sites selected to participate. One of our pediatric specialists is a lead researcher on the project.

UH Rainbow Babies & Children’s researchers are taking a two-pronged approach to youth-onset type 2 diabetes (T2D) to understand the epidemiology of the disorder and how it differs from the adult disease. UH Rainbow is one of the original 15 sites that were part of the groundbreaking TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth) trial to evaluate treatment regimens and the clinical course of T2D in youth. Adolescents were followed for two to six years in the follow-up TODAY2 study, focusing on retinal disease, vascular changes to the heart, signs of clinical nerve damage and kidney damage. The trial’s results revealed T2D is much more aggressive in youth, diabetes-related complications occur at a more rapid pace, lifestyle intervention alone is not adequate, and aggressive intervention early on is essential.

The TODAY study results impacted national T2D guidelines. In January 2019, ADA guidelines for the treatment of youth onset T2D changed to initiate new therapies and much more aggressive medical and drug treatment therapies just after diagnosis. The guidelines also call for general pediatricians to screen more aggressively for the disease in high-risk families, children of others who had gestational diabetes mellitus, and overweight and obese youth.