Among patients diagnosed with type 2 diabetes (T2D) before age 40, the researchers found a more than 5-fold increased risk of all-cause and cardiovascular mortality compared to a matched control group without T2D. The findings, published by researchers from Inha University School of Medicine in South Korea, will be presented in the form of an oral summary at the upcoming annual meeting of the European Association for the Study of Diabetes.
In addition to a significantly increased risk of death from CV or any cause, the researchers, led by Dr Da Hye Seo of Inha University School of Medicine, found that those with early T2D were 7 times more likely to be hospitalized with heart failure than controls. matched.
In their research, Seo et al tapped the Korean National Health Insurance Service (NHIS) database, identified more than 600,000 patients with T2D and matched them in a 2:1 ratio to more than 1.2 million people without the disease.
“In this large population-based cohort study, being younger at the time of T2D diagnosis was associated with an increased relative risk of death and cardiovascular complications compared to those in the same group without diabetes,” said study co-author Seong Bin Hong. MD, PhD, also from Inha University College of Medicine, in the current situation. “Care for young people with diabetes, which has traditionally focused on type 1 diabetes, should focus more on type 2 diabetes. What’s more, effective healthcare policies around screening, early diagnosis and treatment will help combat the future rise of heart disease. And the blood vessels in this young population are increasingly presenting and at high risk.”
“Care for young people with diabetes, which has traditionally focused on type 1 diabetes, should focus more on type 2 diabetes. What’s more, effective healthcare policies around screening, early diagnosis and treatment will help combat the future rise of heart disease. And the blood vessels in this young population are increasingly presenting and at high risk.”
As a context for their research, Seo et al point to the global increase in diagnoses of T2D in young adults, and describe a more aggressive form of the disease in the population that is associated with the early development of vascular complications in particular. Their study was designed to investigate the relationship between mortality and CVD outcomes in relation to the age of T2D diagnosis.
The final study cohort with T2D identified from the Korean NHIS database between 2012 and 2014 numbered 634,350 and the average age of the participants was 56 years at the time of diagnosis. Controls, selected from the general population and matched 2:1 by sex, age, and history of CVD, numbered 1268700.
The primary study outcomes of interest, according to the researchers, were all-cause mortality, CV mortality, coronary heart disease (CHD), acute myocardial infarction (AMI), stroke, hospitalization for heart failure (HHF), and 3 main points. Adverse cardiovascular events (MACE). According to the study, primary analyzes were performed using Cox proportional hazards models in those without prior CVD, and the analysis was repeated in the entire group.
Over a median follow-up of 5.7 years, 40% of those with early T2D and 23% of controls experienced a primary outcome event. The greatest increased risk for most of the primary outcomes compared to the control participants, according to the researchers, was among those diagnosed with T2D at age 40. Specifically, they identified in the adjusted analyzes a more than 5-fold increase in the observed risk for all-cause mortality (HR, 6.08) [95% Ci, 5.50-6.72]), for CV mortality (HR, 5.53.2) [95% CI, 4.29-7.14]), and CHD (HR, 5.10.1) [95% CI, 4.91-5.30]; and a 7-fold increase in the risk of developing HHF (HR, 7.19.1) [95% CI, 6.72-7.60]).
The researchers found that the risks for all events decreased with each subsequent decade in the age of diagnosis, but that the increase in the risk of primary outcomes associated with early onset of T2D remained significant: among people diagnosed with T2D at age ≥91 years, Seo et al report, risk All-cause mortality (HR, 1.29 [95% CI, 1.21-1.37]), CV mortality rate (HR, 1.32 [95% CI, 1.15-1.51]), HHF (HR, 2.95.35) [95% CI, 2.54-3.42]), and CHD (HR, 3.66.00) [95% CI, 3.16-4.24]) were all significantly lower compared to matched controls of the same age without T2D.
They conclude, “Our findings clearly highlight the serious health effects of developing type 2 diabetes at an early age and the importance of efforts to prevent diabetes in early life.”
While their study was large, the authors note that the nature of the observation precludes control for confounding factors. They also noted that the study is limited to a relatively short follow-up and its use of a data set from South Korea, which limits generalizability to other populations.
Siu DH, Chu Wei, Kim et al. Association between age at diagnosis of type 2 diabetes and cardiovascular risk and mortality: a nationwide population study. The conclusion was presented at the 58th meeting of the European Association for the Study of Diabetes. from 19 to 23 September 2022; Stockholm, Sweden. Session SO 74.