Younger age at type 2 diabetes diagnosis linked to higher risk for mortality
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Being diagnosed with type 2 diabetes at age 40 years or younger is associated with higher risks for mortality and cardiovascular disease, according to a presenter at the European Association for the Study of Diabetes annual meeting.
In findings from more than 634,000 people with type 2 diabetes in South Korea, type 2 diabetes diagnosis at age 40 years or younger was associated with a more than six times higher risk for mortality, a more than five times higher risk for CVD mortality, and a more than seven times higher risk for heart failure compared with those without diabetes
“These nationwide data suggest that the mortality and cardiovascular harm associated with type 2 diabetes differs markedly by the age at diagnosis, with the highest mortality and CVD outcome risks in those with early diagnosed type 2 diabetes,” Da Hea Seo, MD, PhD, assistant professor of medicine at Inha University School of Medicine in Incheon, South Korea, told Healio. “The excess risk related to early-onset diabetes mandates more attention to preventive strategies and more intensive CV intervention in younger individuals with type 2 diabetes.”
Seo and colleagues conducted a population cohort study of 634,350 people with newly diagnosed type 2 diabetes with data available in the Korean National Health Insurance Service from 2012 to 2014. The type 2 diabetes cohort was matched, 1:2, by age, sex and previous history of CVD with a control group of people without diabetes. All-cause mortality, CVD mortality, coronary heart disease, acute myocardial infarction, stroke, hospitalization for heart failure, and 3-point major adverse CV event outcomes were collected. Follow-up was conducted until 2019.
The study cohort was followed for a mean of 5.67 years. Adults with type 2 diabetes diagnosed at age 40 years or younger had increased risks for total mortality (adjusted HR = 6.08; 95% CI, 5.5-6.72), CVD mortality (aHR = 5.53; 95% CI, 4.29-7.14), hospitalization for heart failure (aHR = 7.19; 95% CI, 6.72-7.7) and CHD (aHR = 5.1; 95% CI, 4.91-5.3) compared with controls. The risks for outcomes declined progressively with older age at diagnosis, though all risks remained significantly higher for adults with type 2 diabetes compared with controls. Those diagnosed with type 2 diabetes at age 91 years or older still had an increased risk for total mortality (aHR = 1.29; 95% CI, 1.21-1.37), CVD mortality (aHR = 1.32; 95% CI, 1.15-1.51), hospitalization for heart failure (aHR = 2.95; 95% CI, 2.54-3.42) and CHD (aHR = 3.66; 95% CI, 3.16-4.24) compared with controls.
“Although incremental risks associated with type 2 diabetes were attenuated by the increasing age at diagnosis, it remained significant even in those with type 2 diabetes diagnosed at the age of 80 years or older, including both CVD and non-CVD mortality, suggesting that diabetes screening is needed in all age groups,” Seo said.
Seo said prospective intervention trials are needed to further investigate the effect of CV intervention in people diagnosed with type 2 diabetes at a younger age and whether the risk for mortality and CVD outcomes is reduced.
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Seo D, et al. SO 883. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 19-23, 2022; Stockholm (hybrid meeting).
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