The Legacy Effect in Type 2 Diabetes: Impact of Early Glycemic Control on Future Complications (The Diabetes & Aging Study)

Topic: Type 2 Diabetes, Newly Diagnosed, Early Initiation

Key question: Does the glycemic legacy effect begin as early as the 1st year in real-world populations?

Research Spotlight: “The Legacy Effect in Type 2 Diabetes: Impact of Early Glycemic Control on Future Complications (The Diabetes & Aging Study)” Laiteerapong N, et al. Diabetes Care. 2019 Mar;42(3):416-426.

Background: In patients newly diagnosed with T2D, the UKPDS study found that early glycemic control lowers the risk of diabetes-related end points and has durable effects.

Main outcomes of the study:

A1C ≥ 6.5% in the 1st year after diagnosis was associated with 20% higher risk for micro- and macrovascular events.
There was 29% higher risk of mortality associated with A1C levels 7.0% to <8.0% compared to A1C <6.5%.
This study in people with newly-diagnosed type 2 diabetes (n=34,737) suggests that the legacy effect exists in real-world populations, begins as early as the 1st year after diagnosis, and depends on the level of glycemic exposure.

Key takeaways for healthcare providers:

Research has shown that achieving good glycemic control early in the course of diabetes can lead to sustained reductions in the risk of complications.
Early use of glucose sensors can assess the response to treatment and promote the intensification of therapy as needed.

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The Legacy Effect in Type 2 Diabetes: Impact of Early Glycemic Control on Future Complications (The Diabetes & Aging Study)

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