Early-onset type 2 diabetes ‘more pathogenic’
medwireNews: Data from the Swedish National Diabetes Register support the need for aggressive management of type 2 diabetes when diagnosed at a relatively young age.
When more than 100,000 patients in the registry were stratified by age at diagnosis, those aged 18–44 years had the highest average BMI, at 33.4 versus 28.3 kg/m2 in the oldest group (≥75 years), as well as having the highest glycated hemoglobin (HbA1c) and triglyceride levels and the lowest high-density lipoprotein cholesterol levels of all the age groups. The high HbA1c levels in the youngest group were despite these patients also being the most frequent users of oral antidiabetes agents, at 46%.
These differences persisted over time; in fact, the difference in HbA1c levels between the youngest and two oldest groups worsened by 0.45% during the 8 years after diagnosis, and this remained true when the analysis was restricted to patients with at least 5 years of follow-up and adjusted for medication use and BMI.
The differences were also independent of socioeconomic variables and country of birth, say Soffia Gudbjörnsdottir (University of Gothenburg, Sweden) and co-researchers, and therefore “support the notion that early-onset type 2 diabetes may be a more pathogenic condition per se than later-onset type 2 diabetes.”
But they write in Diabetologia that, regardless of the underlying cause, “these real-life data suggest a need for more aggressive management of type 2 diabetes in younger individuals to lessen life-years lost in this high-risk group.”
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