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.
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