ECEESPE2025 Rapid Communications Rapid Communications 2: Diabetes and Insulin Part 1 (6 abstracts)
Isolated glucosuria in adolescence and early-onset type 2 diabetes: a nationwide cohort study of 1.6 million adolescents
Adi Vinograd 1 , Tsahi T. Lerman 2,3 , Orit Pinhas-Hamiel 3,4,5 , Aya Bardugo 3,6,7 , Cole D. Bendor 6,7,8 , Estela Derazne 3 , Josef Coresh 9 , Ofir Vinograd 10 , Miri Lutski 1,8 , Inbar Zucker 1,3 , Michal Bromberg 1,8 , Tamar Fishman 11 , Gabriel Chodick 8 , Hertzel C. Gerstein 12 , Tali Cukierman-Yaffe 8,13 , Asaf Vivante 3,14 , Adi Leiba 15,16 , Arnon Afek 17,18 , Amir Tirosh 3,13 , Boris Fishman 3,19,20 & Gilad Twig 6,8,13
1The Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel; 2Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel; 3School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; 4Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; 5Juvenile Diabetes Center, Maccabi Health Care Services, Raannana, Israel; 6The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; 7Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel; 8Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; 9Optimal Aging Institute and the Department of Population Health, New York University, Grossman School of Medicine, New York, United States; 10Department of Orthopedics, Shamir (Assaf Harofeh) Medical Center, Rishon LeZion, Israel; 11Pharmacy services, Sheba Tel Hashomer, Ramat Gan, Israel; 12Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada; 13Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; 14Department of Pediatrics B and Pediatric Nephrology Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; 15Nephrology and Hypertension Institute, Samson Assuta Ashdod University Hospital, Ashdod, Israel; 16Faculty of Health Sciences, Joyce & Irving Goldman Medical School at Ben Gurion, University of the Negev, Beer-Sheva, Israel; 17Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; 18The Dina Recanati School of Medicine, Reichman University, Herzliya, Israel; 19Division of Cardiology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; 20The Geriatric Division, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
JOINT282
Background: Identifying populations at risk for early-onset type 2 diabetes (T2D) is crucial due to its rising incidence, delayed diagnosis, aggressive course, and deleterious socioeconomic sequelae.Isolated glucosuria is an uncommon but well-recognized hereditary condition caused by variants in SLC5A2 encoding sodium-glucose co-transporter 2. Data regarding its long-term glycemic outcomes are scarce.
Objective: To assess the risk of developing T2D in young adulthood among adolescents with isolated glucosuria in a large nationwide cohort of 1.61 million adolescents.
Research design and methods: Israeli adolescents (ages 16–19 years) examined prior to compulsory military service between 1993 and 2015 were included. Evaluations comprised medical and socio-demographic assessments. Isolated glucosuria was defined based on persistent findings in at least two repeated urine dipstick tests and normal results from a comprehensive evaluation, including a morning fasting glucose test, a 2-hour 75-gram oral glucose tolerance test, and a biochemistry panel. Data were linked with the Israeli National Diabetes Registry, where incident T2D was defined as an outcome. Cox proportional hazard models were applied.
Results: The study included 1,611,467 individuals (42.5% women), of whom 755 (0.05%) were diagnosed with glucosuria during adolescence. Adolescents with versus without glucosuria were predominantly male (75.0% vs. 57.5%; P<0.001) and had lower rates of overweight and obesity (10.4% vs. 16.3%; P<0.001). During a cumulative follow-up of 23,848,350 person-years, 10,328 T2D cases were recorded, with a mean age at the end of follow-up of 32.6 years (SD 6.8). Ten (1.3%) and 10,318 (0.6%) T2D cases were observed among those with and without glucosuria, respectively, with incidence rates per 100,000 person-years of 87.5 and 43.3. No significant differences in mean BMI (P=0.11) or eGFR (P=0.67) at T2D diagnosis were observed between groups. Individuals with isolated glucosuria had an HR of 2.17 (95% CI, 1.17–4.04) following adjustment for sex, BMI, age, year of study entry, and sociodemographic confounders. The association was accentuated in individuals with lean BMI (i.e. BMI<85th percentile) at baseline and in those without coexisting illness at baseline. Results were consistent in sub-analyses limited to T2D before age 40, stricter outcome definition, and logistic regression [adjusted OR of 2.33 (95% CI, 1.26–4.27).
Conclusions
Isolated glucosuria during adolescence is associated with an increased risk of early-onset T2D, particularly in populations with lean BMI and unimpaired health at baseline. This suggests caution in viewing isolated glucosuria strictly as a benign condition.
Volume 110
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Endocrine Abstracts
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