Study finds the earlier diabetes is diagnosed, the more likely patients will experience severe complications.
New research in The Lancet Diabetes & Endocrinology brings to light the increased health risks associated with early-onset type 2 diabetes (T2D). Unlike the traditional understanding of T2D as an older adult disease, the study demonstrated that those diagnosed at younger ages face more severe health challenges and shorter life expectancies than individuals diagnosed later on in life. In fact, data from the UK Prospective Diabetes Study (UKPDS), spanning over 30 years, shows that younger-onset T2D patients often experience more rapid disease progression, increased complications, and a heightened risk of mortality.
Diabetes is a widespread condition affecting approximately 38.4 million people in the U.S. alone, or 11.6% of the population. Among youth under 20, about 352,000 have been diagnosed with early-onset diabetes, with type 1 being most common. Each year, around 18,200 young people are newly diagnosed with type 1 diabetes, and 5,300 with type 2.
The analysis included over 4,500 participants newly diagnosed with T2D. Those diagnosed before age 40 were categorized as younger-onset, while diagnoses at 40 or older were classified as later-onset. The study assessed seven major health outcomes: diabetes-related mortality, all-cause mortality, myocardial infarction, peripheral vascular disease, stroke, microvascular disease, and diabetes-related complications. Findings indicated that younger-onset T2D patients had poorer outcomes across all of these categories. While later-onset T2D patients had a higher incidence of some individual complications, the younger group exhibited higher overall risks relative to the general population.
One important factor appeared to be the persistent exposure to elevated blood sugar levels in younger patients, which worsens complications over time. The younger-onset group showed higher body mass index (BMI) and lower glycated hemoglobin (HbA1c) levels at diagnosis compared to later-onset individuals. Over the years, however, their HbA1c levels rose significantly, indicating worsening glycemic control, and they also showed increased insulin resistance. This metabolic deterioration was shown through a marked reduction in pancreatic beta-cell function, essential for insulin production. Interestingly, this decrease was most pronounced in the first decade after diagnosis, pointing to the need for aggressive early management.
Another key finding is the higher standardized mortality ratio (SMR) observed in the younger-onset group. When compared to the general population, younger individuals with T2D showed a greater excess mortality rate than their older counterparts. Mortality risks were most elevated among those diagnosed between ages 24 and 35, suggesting that the combination of youth and T2D may strengthen the disease’s impact on longevity.
Treatment strategies in the study, which included diet, insulin, metformin, and sulfonylurea, appeared to yield benefits for later-onset T2D patients in terms of survival and cardiovascular health. However, early-onset patients did not experience the same level of benefit, indicating that current treatment approaches may not be as effective for this group. These findings demonstrate a need for specific interventions designed to address the unique challenges younger T2D patients face.
In light of these insights, early intervention and aggressive management may prove essential to minimizing, or putting an end to, complications in younger-onset T2D patients. Researchers suggest that identifying high-risk individuals and applying targeted therapies could potentially reduce the long-term burden of the disease and improve survival rates. This study contributes valuable knowledge to the ongoing effort to refine diabetes care, particularly for the growing population of younger adults affected by T2D.
Sources:
Mortality risk higher for those diagnosed with type 2 diabetes at younger ages
Future Surge in Diabetes Could Dramatically Impact People Under 20 in U.S.
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