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Temporal trends in co‐morbidities and cardiometabolic risk factors at the time of type 2 diabetes diagnosis in the UK

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journal contribution
posted on 2021-04-28, 15:32 authored by Joanna Ling, Digsu Koye, Luke Buizen, Kamlesh Khunti, Olga Montvida, Sanjoy K Paul

Aim

To evaluate temporal patterns in co‐morbidities, cardiometabolic risk factors and a high atherosclerotic cardiovascular disease (ASCVD) risk population at type 2 diabetes (T2D) diagnosis by age groups and sex.


Materials and Methods

From the UK primary care database, 248,619 people with a new diagnosis of T2D during 2005–2016 were identified. Among people without ASCVD, high ASCVD risk was defined as two or more of current smoker, grade 2+ obesity, hypertension, dyslipidaemia or microvascular disease. Cardiometabolic multimorbidity (CMM) was defined as two or more of cardiovascular disease, microvascular disease, hypertension, dyslipidaemia, grade 2+ obesity or cancer. Temporal patterns in the distribution of cardiometabolic risk factors were evaluated.


Results

While the prevalence of ASCVD was stable over time (approximately 18%), 50% were identified to have a high ASCVD risk (26% and 38% in the 18–39 and 40–49 years age groups, respectively), with an increasing trend across all age groups. Overall, 51% had CMM at diagnosis, increasing during 2005–2016 for the 18–39 years age group by 14%–17%, for the 40–49 years age group by 27%–33%, for the 50–59 years age group by 41%–50%, for the 60–69 years age group by 56%–65%, and for the 70–79 years age group by 65%–80%. People with young‐onset T2D had significantly higher HbA1c, body mass index and lipids at diagnosis (all p < .01). The proportions with an HbA1c of 7.5% or higher in the 18–39 and 40–49 years age groups were 58% and 54%, respectively, significantly and consistently higher over the last decade compared with those aged 50 years or older, with males having higher proportions of 15–26 and 10–18 percentage points, respectively, compared with females.


Conclusions

CMM and high ASCVD risk have been increasing consistently across all age groups and in both sex, in particular CMM in those aged younger than 50 years. Our findings indicate that the European Society of Cardiology–European Association for the Study of Diabetes recommendations need to change to consider people with young‐onset T2D as a high‐risk group, as recommended in the Primary Care Diabetes Europe position statement.

History

Citation

Diabetes, Obesity and Metabolism, Volume 23, Issue 5, May 2021, pp. 1150-1161

Author affiliation

Diabetes Research Centre, College of Life Sciences

Version

  • AM (Accepted Manuscript)

Published in

Diabetes, Obesity and Metabolism: a journal of pharmacology and therapeutics

Volume

23

Issue

5

Pagination

1150-1161

Publisher

Wiley

issn

1462-8902

eissn

1463-1326

Acceptance date

2021-01-14

Copyright date

2021

Available date

2022-01-26

Spatial coverage

England

Language

eng

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