Long-Term Complications and Mortality in Young-Onset Diabetes

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Long-Term Complications and Mortality in Young-Onset Diabetes Type 2 diabetes is more hazardous and lethal than type 1 diabetes Featured Article: Maria I. Constantino, BInfoTech, Lynda Molyneaux, R.N., Frankziska Limacher-Gisler, MClinTPrac, Abdulghani Al- Saeed, M.D., Connie Luo, R.N., Ted Wu, M.D., P.H.D., Stephen M. Twigg, M.D., P.H.D., Dennis K. Yue, M.D., P.H.D., Jencia Wong, M.D., P.H.D. Diabetes Care Volume 36: 3863-3 869 December, 2013

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Page 1: Long-Term Complications and Mortality in Young-Onset Diabetes

Long-Term Complications and Mortality in Young-Onset Diabetes

Type 2 diabetes is more hazardous and lethal than type 1 diabetes

Featured Article:

Maria I. Constantino, BInfoTech, Lynda Molyneaux, R.N., Frankziska Limacher-Gisler, MClinTPrac, Abdulghani Al-Saeed, M.D., Connie Luo, R.N., Ted Wu, M.D., P.H.D., Stephen M. Twigg, M.D., P.H.D., Dennis K. Yue, M.D., P.H.D.,

Jencia Wong, M.D., P.H.D.

Diabetes Care Volume 36: 3863-3869

December, 2013

Page 2: Long-Term Complications and Mortality in Young-Onset Diabetes

STUDY OBJECTIVE 

• To evaluate long-term clinical outcomes and survival in young-onset type 2 diabetes (T2DM) compared with type 1 diabetes (T1DM) with a similar age of onset

Constantino M. I. et al. Diabetes Care 2013;36:3863-3869

Page 3: Long-Term Complications and Mortality in Young-Onset Diabetes

STUDY DESIGN AND METHODS

• Records from the Royal Prince Alfred Hospital Diabetes Clinical Database were matched with the Australian National Death Index

• Mortality outcomes for all subjects until June 2011 were established

• Clinical and mortality outcomes in 354 patients with T2DM, age of onset between 15 and 30 years (T2DM15–30), were compared with T1DM

• Primary comparison was with 470 patients with T1DM with a similar age of onset (T1DM15–30) to minimize the confounding effect of age on outcome

Constantino M. I. et al. Diabetes Care 2013;36:3863-3869

Page 4: Long-Term Complications and Mortality in Young-Onset Diabetes

RESULTS

• Median observation period was 21.4 (interquartile range 14–30.7) and 23.4

• (15.7–32.4) years for the T2DM and T1DM cohorts, respectively

• 71 of 824 patients (8.6%) died

• A significant mortality excess was noted in T2DM15–30 with an increased hazard for death

Constantino M. I. et al. Diabetes Care 2013;36:3863-3869

Page 5: Long-Term Complications and Mortality in Young-Onset Diabetes

RESULTS

• Death for T2DM15–30 occurred after a significantly shorter disease duration and at a relatively young age

• There were more cardiovascular deaths in T2DM15–30

• Albuminuria and less favorable cardiovascular risk factors were greater in T2DM15–30

• Neuropathy scores and macrovascular complications were also increased in T2DM15–30

Constantino M. I. et al. Diabetes Care 2013;36:3863-3869

Page 6: Long-Term Complications and Mortality in Young-Onset Diabetes

Constantino M. I. et al. Diabetes Care 2013;36:3863-3869

Page 7: Long-Term Complications and Mortality in Young-Onset Diabetes

Constantino M. I. et al. Diabetes Care 2013;36:3863-3869

Page 8: Long-Term Complications and Mortality in Young-Onset Diabetes

CONCLUSIONS

• Compared with T1DM, young-onset T2DM is the more lethal phenotype of diabetes and is associated with:

• Greater mortality• More diabetes complications• Unfavorable cardiovascular disease risk factors

Constantino M. I. et al. Diabetes Care 2013;36:3863-3869

Page 9: Long-Term Complications and Mortality in Young-Onset Diabetes

Constantino M. I. et al. Diabetes Care 2013;36:3863-3869

Page 10: Long-Term Complications and Mortality in Young-Onset Diabetes

Constantino M. I. et al. Diabetes Care 2013;36:3863-3869


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