ArticleActa diabetologica2026
Clinical characteristics and intensification patterns in subjects with "early" type 2 diabetes in Italy- an analysis from the AMD annals initiative.
Article in Acta diabetologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeCharacteristics defining "early" type 2 diabetes (T2D) are unclear, and type and timing of treatment intensification with glucose-lowering drugs (GLD) in these patients are understudied.
methodsWithin the AMD Annals Initiative, we evaluated the prevalence and clinical characteristics of early T2D subjects, evaluated by diabetologists and defined according to a recent Delphi Consensus. Patient characteristics of early T2D subjects were compared to those of non-early patients. We also explored the time and mode of first intensification in a longitudinal cohort from 2010 to 2023.
resultsOverall, 127,456 people were seen in 2023, of whom 10,700 (8.39%) showed an early phenotype. Early patients were younger, more often females, had lower HbA1c, used less cardiovascular-related drugs, and had a lower prevalence of cardiovascular disease.
conclusionIn real life, T2D could be considered as early in only ~ 8% of people. Among them, less than 10% received treatment intensification during the first year of observation, although the timing of the introduction of add-on GLD improved during time and drugs with cardiovascular benefit were often chosen as second-line GLD. In longitudinal analysis, of 42,786 early patients initially treated with metformin, 9.37% were prescribed an add-on treatment during 12 months, more frequently represented by SGLT2i, followed by GLP1-RAs and DPP4i. Mean level of HbA1c at treatment intensification improved over time, suggesting an encouraging trend through a proactive approach.
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