Young-onset type 2 diabetes mellitus (T2DM) is associated with greater mortality, increased complications, and unfavorable cardiovascular risk versus type 1 diabetes mellitus (T1DM) with a similar age of onset, according to a study published in Diabetes Care (2013;36:3863-3869).

Maria I. Constantino, BInfoTech, of the Royal Prince Alfred Hospital in Sydney, and colleagues compared clinical and mortality outcomes for 354 patients with T2DM with age of onset between 15 and 30 years (T2DM15-30) and 470 patients with T1DM with a similar age of onset (T1DM15-30). The cohorts were followed for 21.4 and 23.4 years, respectively.

The researchers found that 8.6% of patients died during follow-up. In the T2DM15-30 cohort there was a significant mortality excess (11% vs. 6.8%), with a significant twofold increased risk of death. In the T2DM15-30 cohort, death occurred after a significantly shorter disease duration (26.9 vs. 36.5 years) and at a relatively young age. Significantly more cardiovascular deaths were seen in the T2DM15-30 cohort (50% vs. 30%). Even soon after diabetes onset, the prevalence of albuminuria and less favorable cardiovascular risk factors were greater in the T2DM15-30 cohort, despite equivalent glycemic control and shorter disease duration. Participants with T2DM15-30 also had increased neuropathy scores and macrovascular complications.

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“There is an urgent need for efforts to be redoubled toward diabetes prevention targeted to youth,” the authors concluded