Type 2 diabetes is more hazardous and lethal than type 1 diabetes

RESULTSdFor a median observation period of 21.4 (interquartile range 14–30.7) and 23.4 (15.7–32.4)yearsfortheT2DMandT1DMcohorts,respectively,71of 824patients(8.6%)died. A significant mortality excess was noted in T2DM15–30(11 vs. 6.8%, P = 0.03), with an increased hazard for death (hazard ratio 2.0 [95% CI 1.2–3.2], P = 0.003). Death for T2DM15–30 occurred after a significantly shorter disease duration (26.9 [18.1–36.0] vs. 36.5 [24.4–45.4] years, P = 0.01) and at a relatively young age. There were more cardiovascular deaths in T2DM15–30 (50 vs. 30%,P,0.05).Despiteequivalentglycemiccontrolandshorterdiseaseduration,theprevalence of albuminuria and less favorable cardiovascular risk factors were greater in the T2DM15–30 cohort, even soon after diabetes onset. Neuropathy scores and macrovascular complications were also increased in T2DM15–30 (P , 0.0001). CONCLUSIONSdYoung-onset T2DM is the more lethal phenotype of diabetes and associated with a greater mortality, more diabetes complications and unfavorable cardiovascular disease risk factors than T1DM.

[1]  D. Nathan,et al.  A clinical trial to maintain glycemic control in youth with type 2 diabetes. , 2012, The New England journal of medicine.

[2]  M. Brownell,et al.  High Burden of Kidney Disease in Youth-Onset Type 2 Diabetes , 2012, Diabetes Care.

[3]  L. Prosser,et al.  Estimated morbidity and mortality in adolescents and young adults diagnosed with Type 2 diabetes mellitus , 2012, Diabetic medicine : a journal of the British Diabetic Association.

[4]  Baqiyyah N. Conway,et al.  Mortality Experience of a Low-Income Population With Young-Onset Diabetes , 2012, Diabetes Care.

[5]  T. Davis,et al.  The epidemiology and characteristics of type 2 diabetes in urban, community‐based young people , 2010, Internal medicine journal.

[6]  S. Daniels,et al.  Measures of Arterial Stiffness in Youth With Type 1 and Type 2 Diabetes , 2010, Diabetes Care.

[7]  S. Twigg,et al.  Timing Is Everything: Age of Onset Influences Long-Term Retinopathy Risk in Type 2 Diabetes, Independent of Traditional Risk Factors , 2008, Diabetes Care.

[8]  T. Skrivarhaug,et al.  Long-term mortality in a nationwide cohort of childhood-onset type 1 diabetic patients in Norway , 2006, Diabetologia.

[9]  L. Nyström,et al.  Excess mortality in incident cases of diabetes mellitus aged 15 to 34 years at diagnosis: a population-based study (DISS) in Sweden , 2006, Diabetologia.

[10]  J. Flynn,et al.  Microalbuminuria and abnormal ambulatory blood pressure in adolescents with type 2 diabetes mellitus. , 2005, The Journal of pediatrics.

[11]  T. Hillier,et al.  Complications in young adults with early-onset type 2 diabetes: losing the relative protection of youth. , 2003, Diabetes care.

[12]  S. Manley.  Haemoglobin A1c – A Marker for Complications of Type 2 Diabetes: The Experience from the UK Prospective Diabetes Study (UKPDS) , 2003, Clinical chemistry and laboratory medicine.

[13]  A. J. Swerdlow,et al.  Mortality from heart disease in a cohort of 23,000 patients with insulin-treated diabetes , 2003, Diabetologia.

[14]  A. Dobson,et al.  Effectiveness of the National Death Index for establishing the vital status of older women in the Australian Longitudinal Study on Women's Health , 2000, Australian and New Zealand journal of public health.

[15]  R. Holman,et al.  Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study , 2000, BMJ : British Medical Journal.

[16]  J L Botha,et al.  The British Diabetic Association Cohort Study, I: all‐cause mortality in patients with insulin‐treated diabetes mellitus , 1999, Diabetic medicine : a journal of the British Diabetic Association.

[17]  N. McGrath,et al.  Early presentation of type 2 diabetes mellitus in young New Zealand Maori. , 1999, Diabetes research and clinical practice.

[18]  M. McGill,et al.  A Single Visit Diabetes Complication Assessment Service: a Complement to Diabetes Management at the Primary Care Level , 1993, Diabetic medicine : a journal of the British Diabetic Association.

[19]  R. Klein,et al.  Onset of NIDDM occurs at Least 4–7 yr Before Clinical Diagnosis , 1992, Diabetes Care.