It is “imperative” that patients diagnosed with type 2 diabetes during their 20s, 30s and 40s receive significant support on optimising their treatment and self-management skills, warn researchers in light of a new study on mortality risk.
Younger patients who are diagnosed with the condition have a higher risk of death from cardiovascular (CVD) causes than older patients, according to the Australian researchers.
“Increased clinical attention is imperative for individuals with earlier-onset type 2 diabetes”
They noted that, while type 2 diabetes was once considered a disease largely confined to older people, the global obesity epidemic had seen diagnoses rocket in young adults and adolescents.
In almost all countries, diabetes rates are increasing substantially in adults aged 20-45 years. Rates are also continuing to increase in adults over 45, but not as sharply as in the younger age group.
The increase in the younger adults means there is a steadily growing pool of diabetes patients who are exposed to diabetes for a longer period in their lives, noted the researchers.
Their new study found that the earlier a patient was diagnosed, the higher their risk of death from heart disease and stroke but, unusually, the lower their risk of death from cancer.
The researchers analysed the data of 743,709 Australians with type 2 diabetes. The average age at diagnosis was 59 years, and a total of 115,363 deaths occurred during the study period.
The data showed that for two people of the same age, the one with a 10-year earlier diagnosis had a 20% to 30% increased risk of all-cause mortality and about a 60% increased risk of CVD mortality.
“Additionally, there is a need to identify and screen those at high risk of developing diabetes2
The effects were similar in men and women, said the authors of the research published in Diabetologia, the journal of the European Association for the Study of Diabetes.
The study was led by Professor Dianna Magliano and Professor Jonathan Shaw, both from the Baker Heart and Diabetes Institute in Melbourne.
The study authors said: “An earlier diagnosis of type 2 diabetes – and thus a longer duration of disease – was associated with a higher risk of all-cause mortality, primarily driven by CVD mortality.
They said: “Evidence is accumulating to suggest that earlier onset of type 2 diabetes is associated with an increased risk of complications and comorbidities compared with later onset, and that the development and progression of complications might be more aggressive in those with earlier onset.”
As a result of their findings, the researchers said “increased clinical attention” was “imperative” for individuals with earlier-onset type 2 diabetes.
“Efforts should focus on timely optimisation of individuals’ self-management skills and medical treatment to prevent or reduce the onset of complications and comorbidities,” they stated.
“Additionally, there is a need to identify and screen those at high risk of developing diabetes so that individuals can make lifestyle changes that will prevent or delay the onset of diabetes,” they said.
The authors noted that another interesting finding from the study was that earlier diagnosis of type 2 diabetes was associated with lower mortality from cancer compared with diagnosis at an older age.
While this may appear unusual, the authors highlighted that it was “possible that following a diagnosis of diabetes, people have more frequent contact with the healthcare system, which may increase the likelihood of any present but undiagnosed cancer being detected.”