The Difference in Risk Factors Between Adults With Early-Onset (<40 Years Old) Versus Late-Onset (≥40 Years Old) Type 2 Diabetes in a University Hospital From January 2015-December 2017

Abstract

Background: Diabetes will remain a threat to global health. No longer just a disorder of mature age, there is now a well-recognized trend towards the young. Early diagnosis leads to early intervention and prevention of complications in this susceptible but vital portion of the population.
Objective: To compare the risk factors predisposing adults to early-onset (<40 years old) versus late-onset (≥40 years old) type 2 diabetes at the University of Santo Tomas Hospital from January 2015-December 2017.
Methods: This is a retrospective review of medical records. All adult patients who fulfilled the inclusion criteria from January 2015 to December 2017 were included in the study. Data from charts were reviewed and analyzed.
Results: The early-onset group had a mean age of 34 years, while the late-onset group had a mean age of 51 years. The early-onset diabetics were mostly obese, had higher HbA1c, worse lipid profiles, and had a positive family history of diabetes. Only a BMI of >27.50 kg/m2 was found to be a significant risk factor contributing to early-onset of diabetes. Myocardial infarction and nephropathy were more frequent in the late-onset group while retinopathy was more common in the early-onset group. Lastly, only retinopathy and neuropathy were significantly associated with longer duration of diabetes.
Conclusion: The mean age of Filipinos was at least 5 years younger than the studies done on Caucasians. Most patients in the early-onset group were obese and had worse metabolic profiles. Retinopathy was more common in the early-onset group, while myocardial infarction and neuropathy were more common in the latter.


Key words: risk factors, early-onset diabetes, Philippines

  1. Kim KS, Oh HJ, Kim JW, Lee YK, Kim SK, Park SW, et al. The clinical characteristics of the newly diagnosed early-onset (<40 years old) diabetes in outpatients’ clinic. Korean Diabetes J [Internet]. 2010;34(2):119. Available from: http://dx.doi.org/10.4093/kdj.2010.34.2.119 
  2. Jiménez-Corona A, Rojas R, Gómez-Pérez FJ, Aguilar- Salinas CA. Early-onset type 2 diabetes in a Mexican survey: results from the National Health and Nutrition Survey 2006. Salud pública Méx [Internet]. 2010;52:S27– 35. Available from: http://dx.doi.org/10.1590/ s0036-36342010000700006 
  3. Huo X, Gao L, Guo L, Xu W, Wang W, Zhi X, et al. Risk of non-fatal cardiovascular diseases in early-onset versus late-onset type 2 diabetes in China: a cross-sectional study. The Lancet Diabetes & Endocrinology [Internet]. 2016 Feb;4(2):115–24. Available from: http://dx.doi. org/10.1016/S2213-8587(15)00508-2 
  4. Htike ZZ, Webb D, Khunti K, Davies M. Emerging epidemic and challenges of type 2 diabetes in young adults. Diabetes Management [Internet]. 2015 Nov;5(6):473–83. Available from: http://dx.doi.org/10.2217/dmt.15.39 
  5. Yu H, Xie L-F, Chen K, Yang G-Y, Xing X-Y, Zhao J-J, et al. Initiating characteristics of early-onset type 2 diabetes mellitus in Chinese patients. Chinese Medical Journal [Internet]. 2016 Apr 5;129(7):778–84. Available from: http:// dx.doi.org/10.4103/0366-6999.178959 
  6. Vijayakumar G, Sreehari GK, Vijayakumar A, Jaleel A. Distinct predictors and comorbidities in early-onset type 2 diabetes mellitus among Asian Indians. Metabolic Syndrome and Related Disorders [Internet]. 2017 Nov;15(9):458– 64. Available from: http://dx.doi.org/10.1089/ met.2017.0047 
  7. Yang W, Cai X, Han X, Ji L. Clinical characteristics of young type 2 diabetes patients with atherosclerosis. Feng YM, editor. PLoS ONE [Internet]. 2016 Jul 8;11(7):e0159055. Available from: http://dx.doi.org/10.1371/journal. pone.0159055 
  8. Song SH, Hardisty CA. Early-onset type 2 diabetes mellitus: a harbinger for complications in later years--clinical observation from a secondary care cohort. QJM [Internet]. 2009 Sep 4;102(11):799–806. Available from: http://dx.doi. org/10.1093/qjmed/hcp121 
  9. Chowdhury TA. Complications and cardiovascular risk factors in South Asians and Europeans with early-onset type 2 diabetes. QJM [Internet]. 2002 Apr 1;95(4):241–6. Available from: http://dx.doi.org/10.1093/qjmed/95.4.241 
  10. Song SH. Review: Early-onset type 2 diabetes mellitus: a condition with elevated cardiovascular risk? Diabetes & Vascular Disease [Internet]. 2008 Mar;8(2):61–5. Available from: http://dx.doi.org/10.1177/14746514080080 020201 
  11. Deconinck B, Mathieu C, Benhalima K. Characteristics and cardiovascular complications of a large cohort of adults diagnosed with type 2 diabetes <45 years. Diabetol Metab Syndr [Internet]. 2017 May 2;9(1). Available from: http:// dx.doi.org/10.1186/s13098-017-0227-z 
  12. Park M, Kang YI, Chon S, Oh SJ, Woo JT, Kim SW, et al. The clinical characteristics of young onset diabetes according to etiology based classification. J Korean Diabetes Assoc. 2006;30:190–97. 
  13. Hillier TA, Pedula KL. Complications in young adults with early-onset type 2 diabetes. Diabetes Care [Internet]. 2003 Nov 1;26(11):2999–3005. Available from: http://dx.doi. org/10.2337/diacare.26.11.2999 
  14. Yokoyama H, Okudaira M, Otani T, Takaike H, Miura J, Saeki A, et al. Existence of early-onset NIDDM Japanese demonstrating severe diabetic complications. Diabetes Care. 1997 May;20(5):844–7. doi: 10.2337/ diacare.20.5.844. PMID: 9135953. 
  15. Reddy NG, Venkatesh R, Jayadev C, Gadde SGK, Agrawal S, Mishra P, et al. Diabetic retinopathy and diabetic macular edema in people with early-onset diabetes. Clin Diabetes. 2022 Spring;40(2):222–32. doi: 10.2337/ cd21-0110. Epub 2022 Apr 15. PMID: 35669299; PMCID: PMC9160541. 
  16. Chuang L-M, Soegondo S, Soewondo P, Young-Seol K, Mohamed M, Dalisay E, et al. Comparisons of the outcomes on control, type of management and complications status in early-onset and late-onset type 2 diabetes in Asia. Diabetes Research and Clinical Practice [Internet]. 2006 Feb;71(2):146–55. Available from: http://dx.doi. org/10.1016/j.diabres.2005.05.007 
  17. Nitiyanant W, Tandhanand S, Mahtab H, Zhu XX, Pan CY, Raheja BS, et al. The Diabcare-Asia 1998 study--outcomes on control and complications in type 1 and type 2 diabetic patients. Curr Med Res Opin. 2002;18(5):317–27. doi: 10.1185/030079902125000822. PMID: 12240795. 

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