Younger age of diabetes diagnosis linked to higher risk of CVD death
New research shows that the earlier a person is diagnosed with type 2 diabetes, the higher their risk of death from heart disease and stroke. In almost all countries of the world, diabetes rates are increasing substantially in younger adults, aged 20-45 years. This increase means there is a steadily growing pool of diabetes patients who are exposed to diabetes for a longer period in their lives.
This study analysed the data of 743,709 Australians with type 2 diabetes who were registered on the National Diabetes Services Scheme between 1997 and 2011. All-cause mortality and mortality due to cardiovascular disease (CVD), cancer and all other causes were identified. The median age at type 2 diabetes diagnosis was 59 years. The authors said: “An earlier diagnosis of type 2 diabetes, and thus a longer duration of disease, was associated with a higher risk of all-cause mortality, primarily driven by CVD mortality.”
The data showed that for two people of the same age, the one with a 10-year earlier diagnosis (equivalent to 10 years’ longer duration of diabetes) had a 20% to 30% increased risk of all-cause mortality and about a 60% increased risk of CVD mortality. The effects were similar in men and women.
Interestingly, earlier diagnosis of type 2 diabetes was associated with lower mortality due to cancer (all cancers and colorectal and lung cancers). While this may appear unusual, the authors point out that, “It is possible that following a diagnosis of diabetes, people have more frequent contact with the healthcare system, which may increase the likelihood of any present but undiagnosed cancer being detected.”
The study suggests that Increased clinical attention is vital for individuals with earlier-onset type 2 diabetes. It also shows that early and aggressive CVD risk factor management is warranted for young-onset type 2 diabetes. There is also a need to identify and screen those at high risk of developing diabetes so that individuals can make lifestyle changes that will prevent or delay the onset of diabetes.
Huo L, Magliano D, Ranciere F, et al. Impact of age at diagnosis and duration of type 2 diabetes on mortality in Australia 1997–2011. Diabetologia 2018; first online 22 Feb https://link.springer.com/article/10.1007/s00125-018-4544-z