Early type 2 diabetes ups death risk in middle age
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People who develop type 2 diabetes before 20 years of age have higher rates of end-stage renal disease, and higher mortality rates, when they reach middle age than those who develop diabetes later in life, new research shows.
Type 2 diabetes has been increasing among children and adolescents in large part because of rising rates of obesity, according to the report in this week’s Journal of the American Medical Association. The impact of early-onset type 2 diabetes on disease outcomes in adulthood, however, is unclear.
To investigate, Dr. Meda E. Pavkov, from the National Institutes of Health in Phoenix, Arizona, and colleagues analyzed data from a 37-year study of Pima Indians. This population is very prone to develop type 2 diabetes, in some cases as early as 3 or 4 years of age.
During follow-up, end-stage renal disease occurred at a rate equivalent to 25 cases per 1000 persons per year among those who became diabetic before age 20, the team found. That was much higher than the rate of 5 cases per 1000 person-years among those who developed diabetes between 20 and 55 years of age.
Similarly, subjects with young-onset diabetes had a natural-cause death rate of 15 deaths per 1000 persons per year, roughly double the rate seen in those with older-onset disease.
“The longer duration of diabetes mellitus by middle age in individuals diagnosed younger than 20 years largely accounts for these outcomes,” the researchers state.
“Because youth-onset diabetes mellitus leads to substantially increased complication rates and mortality in middle age, efforts should focus on preventing or delaying the onset of diabetes,” they add.
SOURCE: Journal of the American Medical Association, July 26, 2006.
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