scholarly journals Temporal Trend in Young-Onset Type 2 Diabetes - the Macrovascular and Mortality Risk: Study of UK Primary Care Electronic Medical Records

2020 ◽  
Author(s):  
Digsu N. Koye ◽  
Joanna Ling ◽  
John Dibato ◽  
Kamlesh Khunti ◽  
Olga Montvida ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Risk Factor ◽  
High Risk ◽  
Mortality Risk ◽  
Cardiometabolic Risk ◽  
Low Risk ◽  
Young Onset ◽  
Onset Type

<b>Objectives: </b>To evaluate temporal prevalence trend, cardiometabolic risk factors, and the risk of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality (ACM) in incident young- and usual-onset type 2 diabetes. <p><b>Research Design and Methods: </b>From the UK primary care database, 370,854 people with new diagnosis of type 2 diabetes from 2000 to 2017 were identified. Analyses were conducted by age groups (18-39, 40-49, 50-59, 60-69, 70-79 years) and high/low risk status without history of ASCVD at diagnosis - ≥ two of current smoking, high SBP, high LDL-C or chronic kidney disease were classified as high-risk. </p> <p><b>Results:</b> Proportion of people aged <50 years at diagnosis increased during 2000-2010 and then stabilised. The incidence rates of ASCVD and ACM declined in people aged ≥50 years, but did not decrease in people <50 years. Compared to people aged ≥50 years, those aged 18-39 years at diagnosis had higher obesity (71% obese), higher HbA1c (8.6%), 71% had high LDL-C, while only 18% were on cardio-protective therapy. Although 2% in this age group had ASCVD at diagnosis, 23% were identified as high-risk. In the 18-39 years group, the adjusted average years to ASCVD /ACM in high-risk individuals (years (95% CI): 9.1 (8.2–10.0) /9.3 (8.1–10.4)) were similar to those with low-risk (years (95% CI): 10.0 (9.5 – 10.5) /10.5 (9.7–11.2)). However, individuals ≥50 years with high-risk were likely to experience an ASCVD event 1.5 - 2 years earlier and death 1.1 – 1.5 years earlier compared to low-risk groups (p<0.01). </p> <p><b>Conclusions: </b>Unlike usual-onset,<b> </b>young-onset type 2 diabetes have similar cardiovascular and mortality risk irrespective of their cardiometabolic risk factor status at diagnosis. The guidelines on the management of young-onset type 2 diabetes for intensive risk-factor management and cardioprotective therapies need to be urgently re-evaluated through prospective studies.<b> </b></p>

scholarly journals Temporal Trend in Young-Onset Type 2 Diabetes - the Macrovascular and Mortality Risk: Study of UK Primary Care Electronic Medical Records

2020 ◽  
Author(s):  
Digsu N. Koye ◽  
Joanna Ling ◽  
John Dibato ◽  
Kamlesh Khunti ◽  
Olga Montvida ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Risk Factor ◽  
High Risk ◽  
Mortality Risk ◽  
Cardiometabolic Risk ◽  
Low Risk ◽  
Young Onset ◽  
Onset Type

<b>Objectives: </b>To evaluate temporal prevalence trend, cardiometabolic risk factors, and the risk of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality (ACM) in incident young- and usual-onset type 2 diabetes. <p><b>Research Design and Methods: </b>From the UK primary care database, 370,854 people with new diagnosis of type 2 diabetes from 2000 to 2017 were identified. Analyses were conducted by age groups (18-39, 40-49, 50-59, 60-69, 70-79 years) and high/low risk status without history of ASCVD at diagnosis - ≥ two of current smoking, high SBP, high LDL-C or chronic kidney disease were classified as high-risk. </p> <p><b>Results:</b> Proportion of people aged <50 years at diagnosis increased during 2000-2010 and then stabilised. The incidence rates of ASCVD and ACM declined in people aged ≥50 years, but did not decrease in people <50 years. Compared to people aged ≥50 years, those aged 18-39 years at diagnosis had higher obesity (71% obese), higher HbA1c (8.6%), 71% had high LDL-C, while only 18% were on cardio-protective therapy. Although 2% in this age group had ASCVD at diagnosis, 23% were identified as high-risk. In the 18-39 years group, the adjusted average years to ASCVD /ACM in high-risk individuals (years (95% CI): 9.1 (8.2–10.0) /9.3 (8.1–10.4)) were similar to those with low-risk (years (95% CI): 10.0 (9.5 – 10.5) /10.5 (9.7–11.2)). However, individuals ≥50 years with high-risk were likely to experience an ASCVD event 1.5 - 2 years earlier and death 1.1 – 1.5 years earlier compared to low-risk groups (p<0.01). </p> <p><b>Conclusions: </b>Unlike usual-onset,<b> </b>young-onset type 2 diabetes have similar cardiovascular and mortality risk irrespective of their cardiometabolic risk factor status at diagnosis. The guidelines on the management of young-onset type 2 diabetes for intensive risk-factor management and cardioprotective therapies need to be urgently re-evaluated through prospective studies.<b> </b></p>

scholarly journals Temporal Trend in Young-Onset Type 2 Diabetes—Macrovascular and Mortality Risk: Study of U.K. Primary Care Electronic Medical Records

Diabetes Care ◽  
2020 ◽  
Vol 43 (9) ◽  
pp. 2208-2216 ◽  
Author(s):  
Digsu N. Koye ◽  
Joanna Ling ◽  
John Dibato ◽  
Kamlesh Khunti ◽  
Olga Montvida ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Electronic Medical Records ◽  
Mortality Risk ◽  
Medical Records ◽  
Temporal Trend ◽  
Young Onset ◽  
Onset Type

High risk of conversion to diabetes in first-degree relatives of individuals with young-onset type 2 diabetes: a 12-year follow-up analysis

2017 ◽  
Vol 34 (12) ◽  
pp. 1701-1709 ◽  
Author(s):  
Y. Zhang ◽  
A. O. Y. Luk ◽  
E. Chow ◽  
G. T. C. Ko ◽  
M. H. M. Chan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Young Onset ◽  
Onset Type ◽  
First Degree Relatives

522-P: Long-Term Renal Outcomes in Young Onset Type 2 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 522-P
Author(s):  
TIMOTHY MIDDLETON ◽  
STEVE CHADBAN ◽  
LYNDA M. MOLYNEAUX ◽  
MARIO I. D'SOUZA ◽  
MARIA I. CONSTANTINO ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Onset ◽  
Onset Type ◽  
Renal Outcomes

scholarly journals Kidney Disease and Youth Onset Type 2 Diabetes: Considerations for the General Practitioner

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Allison B. Dart ◽  
Elizabeth A. Sellers ◽  
Heather J. Dean
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Kidney Disease ◽  
Complex Disease ◽  
Early Adulthood ◽  
Primary Care Providers ◽  
High Risk Group ◽  
Care Providers ◽  
Onset Type

Youth onset type 2 diabetes (T2DM) continues to increase worldwide, concomitant with the rising obesity epidemic. There is evidence to suggest that youth with T2DM are affected by the same comorbidities and complications as adults diagnosed with T2DM. This review highlights specifically the kidney disease associated with youth onset T2DM, which is highly prevalent and associated with a high risk of end-stage kidney disease in early adulthood. A general understanding of this complex disease by primary care providers is critical, so that at-risk individuals are identified and managed early in the course of their disease, such that progression can be modified in this high-risk group of children and adolescents. A review of the pediatric literature will include a focus on the epidemiology, risk factors, pathology, screening, and treatment of kidney disease in youth onset T2DM.

Predicting young-onset type 2 diabetes mellitus with metabolic syndrome components in healthy young adults

2018 ◽  
Vol 72 (9) ◽  
pp. e13238
Author(s):  
Chung-Ze Wu ◽  
Jin-Sheun Chen ◽  
Yuh-Feng Lin ◽  
Chang-Hsun Hsieh ◽  
Jiunn-Diann Lin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Type 2 Diabetes Mellitus ◽  
Young Adults ◽  
Young Onset ◽  
Onset Type ◽  
Metabolic Syndrome Components

scholarly journals Reduced beta cell function in offspring of mothers with young-onset type 2 diabetes

Diabetologia ◽  
2006 ◽  
Vol 49 (8) ◽  
pp. 1876-1880 ◽  
Author(s):  
R. Singh ◽  
E. Pearson ◽  
P. J. Avery ◽  
M. I. McCarthy ◽  
J. C. Levy ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Beta Cell ◽  
Beta Cell Function ◽  
Cell Function ◽  
Young Onset ◽  
Onset Type

Abstract 190: Use of Intensive Glycemic Management in Older Adults With Diabetes. An Analysis From the Diabetes Collaborative Registry

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Suzanne V Arnold ◽  
Kasia J Lipska ◽  
Jingyan Wang ◽  
Leo Seman ◽  
Sanjeev N Mehta ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
High Risk ◽  
Glucose Control ◽  
Low Risk ◽  
Minimal Risk ◽  
Tight Control ◽  
Poor Control ◽  
Intensively Managed

Background: Older adults with diabetes are less likely to benefit and more likely to be harmed by intensive glucose control. Prior research has shown that many older adults continue to be intensively managed despite guidelines that recommend that treatment targets should be relaxed in these patients. As many new agents have been introduced with minimal risk of hypoglycemia, we examined contemporary data to understand to what extent older patients with diabetes are still intensively managed with agents that can cause hypoglycemia. Methods: We examined A1c and treatment data in adults ≥75 years with type 2 diabetes from 151 US outpatient sites in DCR. Patients were categorized as poor control (A1c >9%), moderate control (A1c >8-9%), conservative control (A1c 7-8%), tight control/low-risk agents (A1c <7% on meds with low risk for hypoglycemia), and tight control/high-risk agents (A1c <7% on insulin, sulfonylureas, or meglitinides). Adults with A1c <7% on no glucose-lowering medications were excluded. We used hierarchical logistic regression to examine patient and site factors associated with tight control/high-risk agents vs. conservative control or tight control/low-risk agents. Results: Among 30,696 older adults with diabetes, 5,596 (18%) had moderate or poor control, 9,227 (30%) conservative control, 7,893 (26%) tight control/low-risk agents, and 7,980 (26%) tight control/high-risk agents (Fig. A). Older age, male sex, heart failure, chronic kidney disease, and coronary artery disease were each independently associated with a greater odds of tight control/high-risk agents (Fig. B). After adjusting for patient factors, there were no differences among practice specialties (endocrinology, primary care, cardiology) in how aggressively patients were managed. Conclusion: Despite greater availability of agents that do not cause hypoglycemia, a quarter of older adults with type 2 diabetes are tightly controlled with high-risk medications. These results suggest potential overtreatment of a substantial proportion of patients. Efforts are needed to provide more specific guidance on how to safely treat older adults with diabetes (both through targeting treatment with low-risk agents and through de-escalation of glucose control) and then to efficiently translate that guidance into busy clinical practice.

scholarly journals The Effect of Replacing Carbohydrate-based Breakfast Foods with Eggs on Cardiometabolic Risk Factors in Adults at Risk for Type 2 Diabetes (P08-045-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kevin Maki ◽  
Orsolya Palacios ◽  
Mary Buggia ◽  
Mary Dicklin ◽  
Marjorie Bell ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
At Risk ◽  
Risk Factor ◽  
Insulin Sensitivity ◽  
Cardiometabolic Risk ◽  
Dietary Intervention ◽  
Density Lipoprotein ◽  
Cardiometabolic Health ◽  
Cardiometabolic Risk Factor

Abstract Objectives To assess the effect of breakfast egg intake, vs. energy-matched carbohydrate (CHO)-based foods, on insulin sensitivity and markers of cardiometabolic health in adults at-risk for type 2 diabetes. Methods Overweight or obese adults with prediabetes and/or metabolic syndrome were included in this randomized crossover study consisting of two 4-wk dietary intervention periods, separated by a ≥4 wk washout. During each intervention, subjects consumed study products containing either 2 eggs/d for 6 d/wk (12 eggs/wk) or energy-matched CHO-based foods for breakfast. Percent changes from baseline were assessed for insulin sensitivity; CHO metabolism; lipid metabolism, including lipoprotein lipids, subfactions and particle sizes; high-sensitivity C-reactive protein (hs-CRP); and blood pressures (BP). Results Overall, 30 subjects (11 male; 19 female) with mean age of 53.5 ± 1.9 y and body mass index (BMI) of 31.9 ± 0.7 kg/m2 provided evaluable data. Median low-density lipoprotein cholesterol (LDL-C) decreased by 6.0% from a baseline of 119 mg/dL after 4-wk intake of the CHO breakfast foods, which was larger than the 2.9% reduction during the egg condition (P = 0.023 between diets). Mean systolic blood pressure was reduced significantly more during the egg condition vs. the CHO condition (2.7% vs. 0.0%, respectively, P = 0.018) from a baseline value of 127 mmHg. None of the other cardiometabolic risk factor parameters showed significant differences in response between diet conditions. Conclusions Intake of 12 eggs/wk for breakfast, vs. energy matched CHO-based foods, did not adversely affect the cardiometabolic risk factor profile in men and women at risk for diabetes. Funding Sources American Egg Board/Egg Nutrition Center, Park Ridge, IL Supporting Tables, Images and/or Graphs

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