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12-19-2022 | Early onset | News

Global type 2 diabetes burden increasing in adolescents and young adults

Author: Eleanor McDermid

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medwireNews: The incidence and burden of type 2 diabetes in young people aged 15–39 years are increasing worldwide, show data from the Global Burden of Disease Study.

High BMI was the main contributor to this rise; however, a separate meta-analysis looking at children with type 2 diabetes highlights that about a quarter do not have obesity at diagnosis, suggesting heterogeneous factors underlying young-onset type 2 diabetes.

The Global Burden of Disease Study analysis was conducted by Fan Wang (Harbin Medical University, China) and colleagues and is published in The BMJ.

They found that the age-standardized incidence rate of type 2 diabetes per 100,000 people aged 15–39 years rose from 117.22 in 1990 to 183.36 in 2019. Likewise, the age-standardized rate of disability-adjusted life–years (DALYs) associated with type 2 diabetes rose from 106.34 to 149.61 per 100,000 people.

The greatest burden of type 2 diabetes in the young was observed in countries with a low-middle or middle sociodemographic index. High BMI accounted for about two-thirds of the DALYs, but this varied according to country sociodemographic index, ranging from about 85% in those with a high index to 52% with a low index.

The overall proportion of DALYs accounted for by high BMI also increased over time, from about 40–45% in 1990 to about 66–69% in 2019.

“Therefore, weight control and management are essential in reducing the burden of early onset type 2 diabetes,” say the researchers.

The challenge of type 2 diabetes in children: Click through for more information on the roles that dietetics, surgery, and medication can play in improving outcomes.

However, the systematic review and meta-analysis, conducted by M Constantine Samaan (McMaster University, Hamilton, Ontario, Canada) and published in JAMA Network Open, suggests a need to consider multiple factors contributing to type 2 diabetes risk in young people.

The analysis included data from 8942 participants, aged 18 years or younger, of 53 studies, of which 46% were cross-sectional, 40% retrospective cohort studies, and 14% prospective cohort studies.

In total, 75% of participants had obesity, with a similar proportion recorded as having this at the point of type 2 diabetes diagnosis. The reported prevalence of both overweight and normal weight across the studies ranged from 0% to 44%.

In subgroup analyses, obesity was more common in boys than girls with type 2 diabetes, and its prevalence varied by ethnicity, being more common in White children (90%) and least common in those of Asian ethnicity (65%).

The researchers believe that “obesity-independent insulin secretory defects and insulin resistance and other factors play important roles in the development of diabetes” in children without obesity, and call for additional study of this subgroup.

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

BMJ 2022; 379: e072385
JAMA Netw Open 2022; 5: e2247186

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