Young adults with DM are at high CVD risk

  • Saydah SH & al.
  • Diabetes Care
  • 20 Jun 2019

  • International Clinical Digest
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Takeaway

  • Young adults with diabetes mellitus (DM) have high rates of cardiometabolic risk factors.

Why this matters

  • As of 2015, 4.6 million adults age 18-44 years had diabetes, with an annual 4.3% increase from 1988 to 1994.
  • This group represents a future population with greater morbidity and mortality, loss of QoL, and health care system burden.

Study design

  • Data from the National Health and Nutrition Examination Survey, 2007-2016.
  • Funding: None.

Key results

  • Compared with older adults, young adults (ages 18-44 years) with diabetes reported less:
    • Lipid-lowering medication use: 20.5% vs 55.5%; and
    • Antihypertensives use: 29.3% vs 63.7%.
  • Among those with diabetes, 25.5% of younger and 12.6% of older adults had HbA1c >9% (75 mmol/mol).
  • After adjustment for age, sex, race/ethnicity, poverty-to-income ratio, and health insurance status, more young adults with vs without diabetes had:
    • Total-to-HDL (high-density lipoprotein) cholesterol ratio ≥5.9: 22.8% vs 8.8% (95% CI, 9.4-18.5); and
    • BP ≥140/90 mmHg: 9.5% vs 5.4% (95% CI, 1.3-7.0).
  • With diabetes, more younger vs older adults had total-to-HDL cholesterol ratio ≥5.9:
    • 22.8% vs 12.5% (95% CI, 4.6-14.5).

Limitations

  • Did not distinguish between diabetes types 1 and 2.
  • Multiple survey cycles combined.
  • Diabetes, income, and health insurance status self-reported.
  • Cross-sectional data.