Early-onset T2D, defined as diagnosed before age 40, is increasingly prevalent and may be a more aggressive disease than later-onset T2D, with faster beta cell deterioration, that is less responsive to medications. We estimated the prevalence of diagnosed and undiagnosed early-onset T2D in the US between 1999 and 2020 using the nationally representative NHANES database.
Data from a longitudinal series of cross-sectional surveys of US participants conducted every two years from 1999-2020 were analyzed retrospectively. Participants with early-onset T2D were identified based on a diagnosis of T2D before age 40 (diagnosed T2D), or a fasting glucose ≥126 mg/dL or HbA1c ≥6.5% in those aged <40 years without a T2D diagnosis (undiagnosed T2D).
The estimated number of participants with undiagnosed and diagnosed early-onset T2D in the US increased from 493,000 and 3,869,000 during the 1999-2000 survey cycle to 1,112,000 and 5,560,000 during 2017-2020, respectively (Figure). The prevalence rate for undiagnosed early-onset T2D increased significantly by 46% per 10-year time-period between 1999 and 2020 (OR 1.461, p<0.05), whereas the rate for diagnosed early-onset T2D remained stable.
NHANES data indicate that undiagnosed early-onset T2D is increasing in prevalence over time in the US, suggesting more attention is needed to diagnose and treat younger adults with T2D to improve health outcomes.
C. Lee: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. K. Boye: Employee; Eli Lilly and Company. B. Bergman: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. S.E. Williamson: Consultant; Eli Lilly and Company, Takeda Pharmaceutical Company Limited, GlaxoSmithKline plc, Novo Nordisk, Lundbeck. D.R. Nelson: Employee; Eli Lilly and Company.
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