Do associations between age at diagnosis of type 2 diabetes and vascular risk factors vary by ethnicity and deprivation?
Methods
Utilising the Clinical Practice Research Datalink, we matched 16-50-year-old individuals with newly diagnosed type 2 diabetes to ∼10 individuals without using sex, age and primary care practice. Differences in BMI, obesity, LDL-cholesterol, HbA1c, and hypertension between individuals with vs without type 2 diabetes across sex, age, ethnicity and deprivation quintiles were explored using generalised linear models.
Results
We included 108,061 individuals (45.6% women) with newly diagnosed type 2 diabetes and 829,946 controls. BMI, obesity, LDL-cholesterol, and hypertension were higher in individuals with vs without type 2 diabetes. Across both sexes, all ethnic groups and deprivation quintiles, these differences were larger with an earlier age, particularly for BMI and obesity. Association between age and HbA1c were variable across subgroups. Differences in BMI, obesity, and hypertension (individuals with vs without diabetes) were largest in White individuals and with less deprivation.
Conclusions
The increased vascular risk phenotype associated with an earlier age of diagnosis of type 2 diabetes was consistent across ethnic and deprivation groups. Population-based strategies are needed to address the risk associated with early-onset type 2 diabetes, especially weight-management-based strategies.
Funding
Type 2 Diabetes (T2D) in 16 – 40 year olds: A Multifactorial Management Intervention to Address Multimorbidity in Early-Onset T2D in Adults (The M3 Research Programme)
This study was supported by the National Institute for Health and Care Research (NIHR) under its Programme Grants for Applied Research Programme (NIHR201165), as well as by the NIHR Leicester Biomedical Research Centre and the NIHR Applied Research Collaboration East Midlands. JG is supported by the Wellcome Trust Leicestershire Healthcare Inequalities Improvement Doctoral Training Programme (223512/Z/21/Z). MJD is co-funded by the NIHR Leicester Biomedical Research Centre and University of Leicester. KK and FZ are supported by the NIHR ARC EM and the NIHR Leicester Biomedical Research Centre.
History
Author affiliation
College of Life Sciences
Population Health Sciences