- Age at diagnosis of type 2 diabetes (T2D) affects survival and cardiovascular (CV) risks.
- Findings suggest appropriate intensity of T2D management may differ by onset age.
Why this matters
- T2D is increasingly diagnosed in adolescents and young adults.
- Overtreatment is common in older adults.
- Swedish National Diabetes Registry data for 318,083 with T2D without baseline CV disease matched with 5 controls each for age, sex, residence county.
- Funding: Swedish Association of Local Authorities Regions; others.
- In median 5.63-year follow-up, those with T2D diagnosed at age ≤40 years had highest excess relative risk for most outcomes, including (95% CIs):
- Total mortality: 2.05 (1.81-2.33);
- CV-related mortality: 2.72 (2.13-3.48);
- Non-CV mortality: 1.95 (1.68-2.25);
- Coronary heart disease: 4.33 (3.82-4.91);
- Acute myocardial infarction: 3.41 (2.88-4.04); and
- Heart failure: 4.77 (3.86-5.89).
- For T2D diagnosed at age >80 years, adjusted relative risks were
- Total mortality: 0.83 (0.80-0.86);
- CV mortality: 0.75 (0.71-0.79); and
- Non-CV mortality: 0.87 (0.83-0.91).
- Risk factor capture in controls not systematic.
- All-Swedish, mostly white population.