{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:03:30Z","timestamp":1778155410602,"version":"3.51.4"},"reference-count":25,"publisher":"American Diabetes Association","issue":"12","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To determine whether clinically accessible parameters early in the course of youth-onset type 2 diabetes predict likelihood of durable control on oral therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>TODAY was a randomized clinical trial of adolescents with type 2 diabetes. Two groups, including participants from all three treatments, were defined for analysis: 1) those who remained in glycemic control for at least 48 months of follow-up and 2) those who lost glycemic control before 48 months. Outcome group was analyzed in univariate and multivariate models as a function of baseline characteristics (age, sex, race\/ethnicity, socioeconomic status, BMI, waist circumference, Tanner stage, disease duration, depressive symptoms) and biochemical measures (HbA1c, C-peptide, lean and fat body mass, insulin inverse, insulinogenic index). Receiver operating characteristic curves were used to analyze HbA1c cut points.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>In multivariate models including factors significant in univariate analysis, only HbA1c and insulinogenic index at randomization remained significant (P &amp;lt; 0.0001 and P = 0.0002, respectively). An HbA1c cutoff of 6.3% (45 mmol\/mol) (positive likelihood ratio [PLR] 3.7) was identified that optimally distinguished the groups; sex-specific cutoffs were 6.3% (45 mmol\/mol) for females (PLR 4.4) and 5.6% (38 mmol\/mol) for males (PLR 2.1).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Identifying youth with type 2 diabetes at risk for rapid loss of glycemic control would allow more targeted therapy. HbA1c is a clinically accessible measure to identify high risk for loss of glycemic control on oral therapy. Adolescents with type 2 diabetes unable to attain a non\u2013diabetes range HbA1c on metformin are at increased risk for rapid loss of glycemic control.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc15-0848","type":"journal-article","created":{"date-parts":[[2015,11,4]],"date-time":"2015-11-04T22:33:39Z","timestamp":1446676419000},"page":"2285-2292","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":66,"title":["HbA1c After a Short Period of Monotherapy With Metformin Identifies Durable Glycemic Control Among Adolescents With Type 2 Diabetes"],"prefix":"10.2337","volume":"38","author":[{"given":"Phil","family":"Zeitler","sequence":"first","affiliation":[{"name":"Section of Endocrinology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Hirst","sequence":"additional","affiliation":[{"name":"George 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