Takeaway
- When adjusted for current age, younger age at type 2 diabetes (T2D) diagnosis is associated with increased risk for mortality and macrovascular/microvascular complications.
- Findings may enable identifying patients in need of more targeted early intensive multifactorial intervention to minimize morbidity/mortality risk.
Why this matters
- T2D is increasingly diagnosed at younger ages.
- Existing treatment guidelines are reactive and do not stratify risk by age at diagnosis.
Study design
- Systematic review/meta-analysis including 26 observational studies comprising 1,325,493 individuals for all-cause mortality outcome, and ranging from 8 studies with n=149,110 for microvascular outcomes to 13 studies with n=566,011 for individual vascular complication outcomes.
- Funding: None.
Key results
- After adjustment for current age, each 1-year increase in age at T2D diagnosis was associated with the following percentage risk decreases and ORs (all P<.001 style="list-style-type:circle;">
- All-cause mortality: 4% (OR, 0.96);
- Macrovascular disease: 3% (OR, 0.97);
- Microvascular disease: 5% (OR, 0.95);
- Coronary heart disease: 2% (OR, 0.98);
- Cerebrovascular disease: 2% (OR, 0.98);
- Peripheral vascular disease: 3% (OR, 0.97);
- Retinopathy: 8% (OR, 0.92);
- Nephropathy: 6% (OR, 0.94); and
- Neuropathy: 5% (OR, 0.95).
Limitations
- Not all identified studies were included.
- T2D definitions may have differed.
- Observational studies are subject to confounding and selection biases.
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