Eye problems present a particular risk for patients with young-onset type 2 diabetes
medwireNews: Young people with type 2 diabetes may be predisposed to developing retinal complications, Australian researchers warn.
Their cross-sectional study of information collected from 3322 individuals over a 30-year period showed that the likelihood of retinopathy was at least twofold higher for those who developed type 2 diabetes between the ages of 15 and 39 years than for those who developed it in their 60s, after adjusting for several known risk factors.
“Together, these results provide evidence of an excess susceptibility to diabetic retinopathy in young-onset type 2 diabetes,” the researchers report.
They add: “[O]ur results support the need for more frequent surveillance of diabetic retinopathy in young-onset type 2 diabetes and aggressive management of known risk factors, which could be reflected in clinical care guidelines.”
The team, led by Timothy Middleton (University of Sydney, New South Wales), examined prospectively collected data from a center providing multidisciplinary secondary and tertiary level care to people with diabetes.
To ensure there was sufficient exposure to diabetes for complications to develop, Middleton et al restricted their analysis to people with at least one assessment for complications between 10 and 25 years after diabetes diagnosis.
Results showed that the highest likelihood for retinopathy occurred in the group that was youngest at the onset of diabetes, at aged 15 to 39 years, and decreased across the older three age groups, who were diagnosed with diabetes when aged 40 to 49 years, 50 to 59 years, and 60 to 69 years.
Importantly, this pattern occurred irrespective of how long individuals had actually had diabetes.
Among individuals who had lived with diabetes for 10 to 14 years, the likelihood of diabetic retinopathy was 2.8-fold greater for those in the youngest versus oldest group at diabetes diagnosis, with a corresponding prevalence of 36% versus 17%.
For participants living with diabetes for 15 to 19 years, there was a 2.2-fold increased likelihood for retinopathy in the youngest versus oldest age group, while for those with 20 to 24 years of diabetes, the likelihood was elevated 5.6-fold. A similar pattern was observed when restricting the analysis to more severe grades of retinopathy.
“In contrast, the risks of albuminuria and macrovascular disease were significantly lower for the group with young-onset type 2 diabetes,” the authors note in Diabetic Medicine.
After living with diabetes for 10 to 14 years, the prevalence of macrovascular disease was 11% in the youngest group at diabetes diagnosis versus 41% in the oldest group.
“This probably reflects the dominant influence of advanced age on macrovascular disease,” the researchers suggest.
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