Skip Navigation
Skip to contents

Diabetes Metab J : Diabetes & Metabolism Journal

Search
OPEN ACCESS

Articles

Page Path
HOME > Diabetes Metab J > Volume 42(3); 2018 > Article
Letter
Letter: Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index (Diabetes Metab J 2018;42:137-46)
Ah Reum Khangorcid
Diabetes & Metabolism Journal 2018;42(3):249-250.
DOI: https://doi.org/10.4093/dmj.2018.0074
Published online: June 19, 2018
  • 3,515 Views
  • 36 Download
  • 3 Web of Science
  • 3 Crossref
  • 2 Scopus

Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

corresp_icon Corresponding author: Ah Reum Khang. Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea. medikar@pnuyh.co.kr

Copyright © 2018 Korean Diabetes Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

prev next
The prevalence of type 2 diabetes mellitus is increasing dramatically across most regions of the world in children, adolescents, and young adults. The overall prevalence of type 2 diabetes mellitus increased by 30.5% from 2001 to 2009 among youth aged 10 to 19 years in the United States [1]. In the United Kingdom, there was a significant increase in the percentage of patients that were newly diagnosed with diabetes at the age of ≤40 years with each subsequent 5-year calendar period between 1991 and 2010. The standardized incidence ratio (per 100,000 population) of young-onset diabetes increased substantially from 217 in 1996–2000 to 598 in 2006–2010 [2]. The prevalence of diabetes is also gradually increasing in a younger and more obese population in South Korea [3].
Accumulating evidence suggests that aggressive disease phenotype is more frequently observed in young-onset type 2 diabetes mellitus, which leads to early development of chronic complications with increased comorbidity burden, serious adverse effects on quality of life, and, consequently, reduced life expectancy. Compared with late-onset type 2 diabetes mellitus, young-onset patients have a higher prevalence of a family history of diabetes and tend to have worse glycemic control [4]. Early onset of type 2 diabetes mellitus in young adults has been associated with a higher glycosylated hemoglobin (HbA1c) level than those who develop diabetes at an older age [567]. Accordingly, young-onset type 2 diabetes mellitus responds poorly to treatments and is associated with a shorter time to initiation of insulin treatment compared with type 2 diabetes mellitus in older adults [8]. Furthermore, young adults with type 2 diabetes mellitus develop adverse metabolic and cardiovascular events much sooner after diagnosis than those who develop type 2 diabetes mellitus at older age [910].
In this issue, Ha et al. [11] report the prevalence and characteristics of newly diagnosed diabetes mellitus patients by age group, with the younger age group (<40 years old, mean 33.6±4.9 years) accounting for 81 of the 912 participants (8.9%). They report that the proportion of participants with both insulin resistance and β-cell dysfunction was increased from 5.7% among those over 65 years of age to 16.1% among those younger than 40 years of age. Young-onset diabetic participants had significantly higher fasting and 30-minute glucose, homeostatic model assessment (HOMA) of insulin resistance, and HbA1c levels than the older participants. The median HOMA-β, insulinogenic index, and disposition index values were significantly lower in the younger people than in the older people. These results demonstrate that there is a distinct pathophysiological difference in type 2 diabetes mellitus between younger and older people. In addition, patients with young-onset diabetes had a higher body mass index, cholesterol level, and diastolic blood pressure and engaged in less physical activity; consequently, metabolic syndrome was more prevalent among younger people. These findings are valuable and meaningful with respect to evaluating the differences between young and old age at initial diagnosis of diabetes. Younger people with diabetes already have more severe metabolic disturbances including obesity and dyslipidemia, which is worsened by a more sedentary lifestyle compared with older participants.
Although type 2 diabetes mellitus develops in young people via similar mechanisms as in older people, its pathogenic entity is characterized by a more aggressive pattern compared with type 2 diabetes mellitus in older people. Younger people with diabetes also had more risk factors known to induce metabolic disturbances, especially a “bad lifestyle.” This bad lifestyle, longer lifetime exposure to hyperglycemia, and more aggressive phenotype in young-onset diabetes will impose a more severe medical and economic burden in the near future. We need to recognize patients with young-onset type 2 diabetes mellitus as a high-risk group and be more aware of this population. Further research to elucidate the risk factors and education to eliminate these risk factors in adolescents and young adults would enable the prevention of young-onset type 2 diabetes mellitus. Moreover, it remains a matter of debate which sort of treatment is most effective and safe for these younger people. There is still a lack of evidence regarding long-term treatment and outcomes of young-onset type 2 diabetes mellitus. It seems important to prospectively follow-up on patients with young-onset type 2 diabetes mellitus and to try to define its natural disease course. A multidisciplinary team approach to improve long-term consequences (e.g., cardiovascular disease and life expectancy) is needed, including interventions to educate patients regarding lifestyle modification, choose proper treatment, and encourage adherence to medication.

CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.

  • 1. Dabelea D, Mayer-Davis EJ, Saydah S, Imperatore G, Linder B, Divers J, Bell R, Badaru A, Talton JW, Crume T, Liese AD, Merchant AT, Lawrence JM, Reynolds K, Dolan L, Liu LL, Hamman RF. SEARCH for Diabetes in Youth Study. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA 2014;311:1778-1786. ArticlePubMedPMC
  • 2. Holden SH, Barnett AH, Peters JR, Jenkins-Jones S, Poole CD, Morgan CL, Currie CJ. The incidence of type 2 diabetes in the United Kingdom from 1991 to 2010. Diabetes Obes Metab 2013;15:844-852. ArticlePubMed
  • 3. Ha KH, Kim DJ. Trends in the diabetes epidemic in Korea. Endocrinol Metab (Seoul) 2015;30:142-146. ArticlePubMedPMC
  • 4. Hillier TA, Pedula KL. Characteristics of an adult population with newly diagnosed type 2 diabetes: the relation of obesity and age of onset. Diabetes Care 2001;24:1522-1527. PubMed
  • 5. Gunathilake W, Song S, Sridharan S, Fernando DJ, Idris I. Cardiovascular and metabolic risk profiles in young and old patients with type 2 diabetes. QJM 2010;103:881-884. ArticlePubMed
  • 6. International Diabetes Federation. Diabetes atlas. 3rd ed. Brussels: International Diabetes Federation; 2006. cited 2018 May 16. Available from: http://www.diabetesatlas.org/resources/previous-editions.html.
  • 7. International Diabetes Federation. Diabetes atlas. 6th ed. Brussels: International Diabetes Federation; 2013. cited 2018 May 16. Available from: http://www.diabetesatlas.org/resources/previous-editions.html.
  • 8. Mast R, Danielle Jansen AP, Walraven I, Rauh SP, van der Heijden AA, Heine RJ, Elders PJ, Dekker JM, Nijpels G, Hugtenburg JG. Time to insulin initiation and long-term effects of initiating insulin in people with type 2 diabetes mellitus: the Hoorn Diabetes Care System Cohort Study. Eur J Endocrinol 2016;174:563-571. ArticlePubMed
  • 9. Song SH. Complication characteristics between young-onset type 2 versus type 1 diabetes in a UK population. BMJ Open Diabetes Res Care 2015;3:e000044.ArticlePubMedPMC
  • 10. Song SH. Early-onset type 2 diabetes: high lifetime risk for cardiovascular disease. Lancet Diabetes Endocrinol 2016;4:87-88. ArticlePubMed
  • 11. Ha KH, Park CY, Jeong IK, Kim HJ, Kim SY, Kim WJ, Yoon JS, Kim IJ, Kim DJ, Kim S. Clinical characteristics of people with newly diagnosed type 2 diabetes between 2015 and 2016: difference by age and body mass index. Diabetes Metab J 2018;42:137-146. ArticlePubMedPMCPDF

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • Trends of Diabetes and Prediabetes Prevalence among Korean Adolescents From 2007 to 2018
      Ji Hyun Kim, Jung Sub Lim
      Journal of Korean Medical Science.2021;[Epub]     CrossRef
    • Age-, sex- and ethnicity-related differences in body weight, blood pressure, HbA1c and lipid levels at the diagnosis of type 2 diabetes relative to people without diabetes
      Alison K. Wright, Paul Welsh, Jason M. R. Gill, Evangelos Kontopantelis, Richard Emsley, Iain Buchan, Darren M. Ashcroft, Martin K. Rutter, Naveed Sattar
      Diabetologia.2020; 63(8): 1542.     CrossRef
    • Remission of type 2 diabetes in a young, hypogonadal man under long-term testosterone therapy: A case report
      Mskhalaya George, Tishova Yulia, Alfaradzh Anas, Kalinchenko Svetlana
      Global Journal of Obesity, Diabetes and Metabolic Syndrome.2020; 7(2): 024.     CrossRef

    • PubReader PubReader
    • Cite this Article
      Cite this Article
      export Copy Download
      Close
      Download Citation
      Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

      Format:
      • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
      • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
      Include:
      • Citation for the content below
      Letter: Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index (Diabetes Metab J 2018;42:137-46)
      Diabetes Metab J. 2018;42(3):249-250.   Published online June 19, 2018
      Close
    • XML DownloadXML Download
    Related articles
    Letter: Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index (Diabetes Metab J 2018;42:137-46)
    Letter: Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index (Diabetes Metab J 2018;42:137-46)
    Khang AR. Letter: Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index (Diabetes Metab J 2018;42:137-46). Diabetes Metab J. 2018;42(3):249-250.
    DOI: https://doi.org/10.4093/dmj.2018.0074.

    Diabetes Metab J : Diabetes & Metabolism Journal
    Close layer
    TOP