Comparison of clinical characteristics and disease burden between early- and late-onset type 2 diabetes patients: a population-based cohort study

• Published in: BMC public health Vol. 23; no. 1; p. 2411
• Main Authors: Wang, Mingqi, He, Yifei, He, Qiao, Di, Fusheng, Zou, Kang, Wang, Wen, Sun, Xin
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.12.2023; BioMed Central; BMC
• Subjects: Age; Cardiovascular diseases; Cohort analysis; Cohort Studies; Comorbid Disease development; Comorbidity; Cost of Illness; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - epidemiology; Disease; Gestational diabetes; Glucose; Health promotion; Humans; Hyperlipidemia; Hyperlipidemias; Hypertension; Hypertension - epidemiology; Insulin; Kidney diseases; Medical prognosis; Metabolism; New-onset type 2 Diabetes; Patients; Population; Population studies; Population-based cohort study; Survival analysis; Young Adult; Young adults; China; New-onset type 2 Diabetes; Population-based cohort study; Comorbid Disease development
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-023-17280-5

The clinical characteristics of early-onset type 2 diabetes (T2D) patients are not fully understood. To address this gap, we conducted a cohort study to evaluate clinical characteristics and disease burden in the new-onset T2D population, especially regarding the progression of diseases. This cohort study was conducted using a population-based database. Patients who were diagnosed with T2D were identified from the database and were classified into early- (age < 40) and late-onset (age ≥ 40) groups. A descriptive analysis was performed to compare clinical characteristics and disease burden between early- and late-onset T2D patients. The progression of disease was compared using Kaplan‒Meier analysis. A total of 652,290 type 2 diabetic patients were included. Of those, 21,347 were early-onset patients, and 300,676 were late-onset patients. Early-onset T2D patients had poorer glycemic control than late-onset T2D patients, especially at the onset of T2D (HbA1c: 9.3 [7.5, 10.9] for early-onset vs. 7.7 [6.8, 9.2] for late-onset, P < 0.001; random blood glucose: 10.9 [8.0, 14.3] for early-onset vs. 8.8 [6.9, 11.8] for late-onset, P < 0.001). Insulin was more often prescribed for early-onset patients (15.2%) than for late-onset patients (14.8%). Hypertension (163.0 [28.0, 611.0] days) and hyperlipidemia (114.0 [19.0, 537.0] days) progressed more rapidly among early-onset patients, while more late-onset patients developed hypertension (72.7% vs. 60.1%, P < 0.001), hyperlipidemia (65.4% vs. 51.0%, P < 0.001), cardiovascular diseases (66.0% vs. 26.7%, P < 0.001) and chronic kidney diseases (5.5% vs. 2.1%, P < 0.001) than early-onset patients. Our study results indicate that patients with newly diagnosed early-onset T2D had earlier comorbidities of hypertension and hyperlipidemia. Both clinical characteristics and treatment patterns suggest that the degree of metabolic disturbance is more severe in patients with early-onset type 2 diabetes. This highlights the importance of promoting healthy diets or lifestyles to prevent T2D onset in young adults.