Introduction: Young-onset type 2 diabetes (T2D) is associated with premature complications and death.
Aim: To assess whether long-term complications and mortality rates differed with younger age at T2D diagnosis over UKPDS 30-year follow-up.
Methods: Using 1977-2007 data from UKPDS participants with newly-diagnosed T2D without diabetes autoantibodies, we analysed standardised mortality ratios (SMR) using UK general population data and incidence rates of pre-specified aggregate outcomes in young and later onset T2D (<40 years vs >40 years), and by 10-year age intervals at diagnosis.
Results: Of 4550 participants (59% male, HbA1c 9.1%), 429 (9.4%) had young-onset T2D. The SMR was higher in young-onset T2D (3.72, 95% CI 2.98-4.64; median follow-up: 18.0 years) than in later-onset T2D (1.54, 1.47-1.61; 17.4 years). At any given age, the incidence of any diabetes-related endpoint, all-cause mortality, microvascular disease, and myocardial infarction was higher with younger age at diagnosis (Figure). Annual mean HbA1c was higher in the first 20 years of follow-up in those with younger compared with later-onset T2D.
Conclusion: The risk of dying relative to the general population is even greater for people diagnosed with T2D at younger ages. The greater risk of complications and poorer glycaemic control in young-onset T2D suggests a need to develop services to identify and support these individuals over their lifetimes.
B. Lin: None. R.L. Coleman: None. F. Bragg: None. E. Maddaloni: Advisory Panel; Novo Nordisk, Merck Sharp & Dohme Corp. Speaker's Bureau; Abbott, Eli Lilly and Company. Consultant; PikDare. Speaker's Bureau; MTD. R.R. Holman: Advisory Panel; Anji Pharmaceuticals, AstraZeneca, Novartis AG. A.I. Adler: None.
