Younger age at T2D diagnosis is linked to worse outcomes

  • Nanayakkara N & al.
  • Diabetologia
  • 14 Dec 2020

  • curated by Miriam Tucker
  • Clinical Essentials
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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.