Success with lifestyle monotherapy in youth with new-onset type 2 diabetes

BACKGROUND: Evidence is lacking to support the efficacy of lifestyle modification as first-line therapy in the clinical management of type 2 diabetes mellitus (T2DM) in adolescents. METHODS: A retrospective chart review of youth diagnosed with T2DM between 1999 and 2008 was conducted. The authors describe the percentage of youth presenting with glycosylated hemoglobin (HbA(1c)) of <9% who achieved/maintained target glycemic control (HbA(1c) <= 7.0%) with lifestyle monotherapy during the year following diagnosis. RESULTS: Among the 275 youth with T2DM, 38% (n=104) presented with an HbA(1c) <9% and were prescribed lifestyle monotherapy at diagnosis. Of the 80 youth who had sufficient follow-up data over 12 months, 54% successfully maintained target glycemic control solely with lifestyle management. The mean HbA(1c) score at diagnosis was lower in youth who where successful on lifestlye monotherapy compared with those who were not successful. CONCLUSIONS: A significant proportion of youth newly diagnosed with T2DM presenting with an HbA(1c) <9% effectively achieved/maintained target glycemic control with lifestyle recommendations alone for 12 months.