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Incidence of complications in young-onset diabetes: Comparing type 2 with type 1 (the young diab study).
Diabetes Res Clin Pract. 2017 Jan; 123:1-8.DR

Abstract

BACKGROUND

There is little data on the incidence of diabetes complications in young onset type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in non European populations.

METHODS

From a tertiary diabetes centre, Chennai, India, we recruited 108 T1DM (defined by abrupt onset of symptoms or diabetic ketoacidosis, absent insulin reserve requiring insulin treatment) and 90 T2DM participants (defined by absence of ketosis, good beta-cell reserve, and good response to oral agents) who were diagnosed between the ages of 10 and 25years, and without any evidence of diabetes complications at diagnosis. We estimated the incidence of various complications (median follow up of five years); retinopathy was defined by presence of at least one definite microaneurysm by retinal photography, nephropathy by urinary albumin excretion ⩾30μg/mg of creatinine, neuropathy by vibration perception threshold ⩾20V on biothesiometry, peripheral vascular disease by an ankle-brachial index <0.9, and ischemic heart disease (IHD) by history of myocardial infarction or coronary revascularization or Q waves on ECG or on drug treatment for IHD.

RESULTS

The mean ages at diagnosis of T1DM and T2DM participants were 17.1±4.2vs. 21.6±3.6years respectively. The incidence of various complications reported in numbers/1000 person years of follow up of T1DM and T2DM were: retinopathy 77.4vs. 78.0/1000 person years, nephropathy, 62.0vs. 58.8, neuropathy 7.8 vs. 13.9 and ischemic heart disease 1.2vs. 5.4. In Cox regression analysis, after adjustment for age, glycated hemoglobin, systolic blood pressure and serum cholesterol, T2DM participants had 2.11 times (95%CI: 1.27-3.51) higher risk of developing any diabetes complication, compared to T1DM.

CONCLUSIONS

Young-onset T2DM have a more aggressive disease course than T1DM.

Authors+Show Affiliations

Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, Gopalapuram, Chennai, India.Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, Gopalapuram, Chennai, India.Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, Gopalapuram, Chennai, India.Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, Gopalapuram, Chennai, India.Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, Gopalapuram, Chennai, India.Emory Global Diabetes Research Center, Rollins School of Public Health, Emory University, Atlanta, USA.Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, Gopalapuram, Chennai, India. Electronic address: http://www.drmohansdiabetes.com.Emory Global Diabetes Research Center, Rollins School of Public Health, Emory University, Atlanta, USA.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27912129

Citation

Amutha, Anandakumar, et al. "Incidence of Complications in Young-onset Diabetes: Comparing Type 2 With Type 1 (the Young Diab Study)." Diabetes Research and Clinical Practice, vol. 123, 2017, pp. 1-8.
Amutha A, Anjana RM, Venkatesan U, et al. Incidence of complications in young-onset diabetes: Comparing type 2 with type 1 (the young diab study). Diabetes Res Clin Pract. 2017;123:1-8.
Amutha, A., Anjana, R. M., Venkatesan, U., Ranjani, H., Unnikrishnan, R., Narayan, K. M. V., Mohan, V., & Ali, M. K. (2017). Incidence of complications in young-onset diabetes: Comparing type 2 with type 1 (the young diab study). Diabetes Research and Clinical Practice, 123, 1-8. https://doi.org/10.1016/j.diabres.2016.11.006
Amutha A, et al. Incidence of Complications in Young-onset Diabetes: Comparing Type 2 With Type 1 (the Young Diab Study). Diabetes Res Clin Pract. 2017;123:1-8. PubMed PMID: 27912129.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence of complications in young-onset diabetes: Comparing type 2 with type 1 (the young diab study). AU - Amutha,Anandakumar, AU - Anjana,Ranjit Mohan, AU - Venkatesan,Ulagamathesan, AU - Ranjani,Harish, AU - Unnikrishnan,Ranjit, AU - Narayan,K M V, AU - Mohan,Viswanathan, AU - Ali,Mohammed K, Y1 - 2016/11/17/ PY - 2016/08/22/received PY - 2016/10/06/revised PY - 2016/11/14/accepted PY - 2016/12/3/pubmed PY - 2017/3/4/medline PY - 2016/12/3/entrez KW - Incidence rate KW - Micro and macro vascular complications KW - T1DM KW - T2DM KW - Young onset SP - 1 EP - 8 JF - Diabetes research and clinical practice JO - Diabetes Res Clin Pract VL - 123 N2 - BACKGROUND: There is little data on the incidence of diabetes complications in young onset type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in non European populations. METHODS: From a tertiary diabetes centre, Chennai, India, we recruited 108 T1DM (defined by abrupt onset of symptoms or diabetic ketoacidosis, absent insulin reserve requiring insulin treatment) and 90 T2DM participants (defined by absence of ketosis, good beta-cell reserve, and good response to oral agents) who were diagnosed between the ages of 10 and 25years, and without any evidence of diabetes complications at diagnosis. We estimated the incidence of various complications (median follow up of five years); retinopathy was defined by presence of at least one definite microaneurysm by retinal photography, nephropathy by urinary albumin excretion ⩾30μg/mg of creatinine, neuropathy by vibration perception threshold ⩾20V on biothesiometry, peripheral vascular disease by an ankle-brachial index <0.9, and ischemic heart disease (IHD) by history of myocardial infarction or coronary revascularization or Q waves on ECG or on drug treatment for IHD. RESULTS: The mean ages at diagnosis of T1DM and T2DM participants were 17.1±4.2vs. 21.6±3.6years respectively. The incidence of various complications reported in numbers/1000 person years of follow up of T1DM and T2DM were: retinopathy 77.4vs. 78.0/1000 person years, nephropathy, 62.0vs. 58.8, neuropathy 7.8 vs. 13.9 and ischemic heart disease 1.2vs. 5.4. In Cox regression analysis, after adjustment for age, glycated hemoglobin, systolic blood pressure and serum cholesterol, T2DM participants had 2.11 times (95%CI: 1.27-3.51) higher risk of developing any diabetes complication, compared to T1DM. CONCLUSIONS: Young-onset T2DM have a more aggressive disease course than T1DM. SN - 1872-8227 UR - https://www.unboundmedicine.com/medline/citation/27912129/Incidence_of_complications_in_young_onset_diabetes:_Comparing_type_2_with_type_1__the_young_diab_study__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8227(16)30423-5 DB - PRIME DP - Unbound Medicine ER -