USA: Type 2 diabetes onset in youth is associated with an increased risk of complications at the time of young adulthood (before the age of 30), a recent study has suggested. The complications were found to be more common among people of minority race and ethnic groups and those with dyslipidemia, hypertension, and hyperglycemia.
The study findings are published in the New England Journal of Medicine.
Type 2 diabetes is a chronic condition in which the body is no longer able to properly utilize the hormone insulin, which regulates blood sugar levels. As a result, the blood sugar levels increase damaging blood vessels and organs over time.
Philip Zeitler, a pediatric endocrinologist at Children's Hospital Colorado, in Aurora, and colleagues aimed to determine the occurrence of related complications in youth diagnosed with type 2 diabetes, as these youths transition to adulthood.
The researchers had previously conducted a multicenter clinical trial (from 2004 to 2011) to evaluate the effects of one of three treatments (metformin, metformin plus rosiglitazone, or metformin plus an intensive lifestyle intervention) on the time to loss of glycemic control in participants who had onset of type 2 diabetes in youth. After the trial completion, participants were transitioned to metformin with or without insulin and were enrolled in an observational follow-up study (performed from 2011 to 2020). The study was conducted in two phases; the results of this follow-up study are reported here.
Assessments for diabetic kidney disease, hypertension, dyslipidemia, and nerve disease were performed annually, and assessments for the retinal disease were performed twice. Complications related to diabetes identified outside the study were confirmed and adjudicated.
The research yielded the following findings:
· At the end of the second phase of the follow-up study (January 2020), the mean age of the 500 participants who were included in the analyses was 26.4 years, and the mean time since the diagnosis of diabetes was 13.3 years.
· The cumulative incidence of hypertension was 67.5%, the incidence of dyslipidemia was 51.6%, the incidence of diabetic kidney disease was 54.8%, and the incidence of nerve disease was 32.4%.
· The prevalence of retinal disease, including more advanced stages, was 13.7% in the period from 2010 to 2011 and 51.0% in the period from 2017 to 2018.
· At least one complication occurred in 60.1% of the participants, and at least two complications occurred in 28.4%.
· Risk factors for the development of complications included minority race or ethnic group, hyperglycemia, hypertension, and dyslipidemia. No adverse events were recorded during follow-up.
"Our findings showed that among participants who had onset of type 2 diabetes in youth, the risk of complications, including microvascular complications, increased steadily over time and affected most participants by the time of young adulthood," concluded the authors.
Reference:
The study titled, "Long-Term Complications in Youth-Onset Type 2 Diabetes," is published in the New England Journal of Medicine.
DOI: https://www.nejm.org/doi/full/10.1056/NEJMoa2100165