Complications Are More Common in Teens and Young Adults with Type 2 Than Type 1 Diabetes

Summary and Comment |
February 28, 2017

Complications Are More Common in Teens and Young Adults with Type 2 Than Type 1 Diabetes

  1. F. Bruder Stapleton, MD

Roughly 8 years after a childhood diabetes diagnosis, 72% of patients with type 2 and 32% of those with type 1 diabetes had at least one complication.

  1. F. Bruder Stapleton, MD

With a growing number of children with type 2 diabetes, clinicians need more information about its natural history and complications. In a prospective observational study at five U.S. sites, researchers examined the prevalence of complications at least 5 years after diagnosis in 1746 patients with type 1 diabetes and 272 with type 2 diabetes diagnosed before age 20 years. Six diabetes-related complications were evaluated: kidney disease, retinopathy, peripheral neuropathy, cardiovascular autonomic neuropathy, arterial stiffness, and hypertension.

At the outcome visit a mean of 7.9 years after diagnosis, patients with type 1 diabetes were older (mean age, 22.1 vs. 17.9 years), and patients with type 2 diabetes had higher body-mass index and mean arterial pressure. However, hemoglobin A1c values did not differ. Overall, 72% of patients with type 2 diabetes compared with 32% of those with type 1 diabetes had at least one diabetes-related complication. Age-adjusted prevalence of each complication except cardiovascular autonomic neuropathy was higher in patients with type 2 diabetes. After adjustment for other risk factors, patients with type 2 diabetes had significantly higher odds of diabetic kidney disease (odds ratio, 2.58), retinopathy (OR, 2.24), and peripheral neuropathy (OR, 2.52).

Comment

Complications of both types of diabetes are frequent in teens and young adults, although type 2 diabetes is particularly dangerous. Careful surveillance for early signs of diabetic complications should be a priority in patients with type 2 diabetes in order to initiate early interventions.

Editor Disclosures at Time of Publication

  • Disclosures for F. Bruder Stapleton, MD at time of publication Editorial boards UpToDate Leadership positions in professional societies American Society of Pediatric Nephrology Foundation (Chair)

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