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Teens with type 2 diabetes more prone to complications than type 1 peers

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Teenagers and young adults with type 2 diabetes develop kidney, nerve, and eye diseases more often than their peers with type 1 diabetes in the years shortly after diagnosis, a major study has found.

US researchers examined how quickly and often youth developed signs of kidney, nerve and eye diseases, among the most common complications of diabetes.

“There’s often the assumption that young people don’t develop complications”

Barbara Linder

They also measured several risk factors for heart disease. Participants had diabetes an average of under eight years at the end of the study, the largest of its kind ever undertaken in the US.

Among the key findings were that nearly 20% of those with type 2 diabetes developed a sign of kidney disease by the end of the study, compared to about 6% with type 1 diabetes.

In addition, among those with type 2, about 18% developed nerve disease, versus about 9% with type 1. Meanwhile, about 9% of type 2 participants developed eye disease, compared to about 6% with type 1.

Measures for two risk factors for heart disease – hypertension and arterial stiffness – were also found to be greater for type 2 but similar for a third factor – cardiovascular autonomic neuropathy.

Though young people with type 2 showed signs of complications more often in nearly every measure than those with type 1, many in both groups developed complications, noted the study authors.

The results are the latest findings from the SEARCH for Diabetes in Youth study, funded by the US National Institutes of Health (NIH) and the Centers for Disease Control and Prevention.

The study, published in the Journal of the American Medical Association, involved 1,746 patients with type 1 diabetes, with an average age of 18, and 272 with type 2, with average age about 22.

“This study highlights the need for early monitoring”

Sharon Saydah

By the age of 21, about a third of participants with type 1 diabetes and about three-quarters of participants with type 2 had at least one complication from diabetes or were at high risk of one.

The researchers looked at factors including glucose control, body mass index, waist-to-height ratio and blood pressure, but could explain why those with type 2 developed more complications than those with type 1.

Study author Dr Barbara Linder, senior advisor for childhood diabetes research within the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases, said: “There’s often the assumption that young people don’t develop complications from diabetes, but that’s just not true.

“We saw that young people with diabetes are developing signs of major complications in the prime of their lives,” said Dr Linder.

“Particularly for youth with type 2, this research demonstrates the clear need to learn how to reduce or delay the debilitating complications of diabetes, itself a huge challenge for young people to manage,” she said.

Study author Dr Sharon Saydah, a senior scientist at the CDC, added: “This study highlights the need for early monitoring for development of complications among young people with diabetes. If young people can delay onset of these complications from diabetes by even a few years, that can ease their burden and lengthen their lives.”

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