Skip to main content

Clinical Features and Microvascular Complications Risk Factors of Early-onset Type 2 Diabetes Mellitus

Current Medical Science volume 39, pages 754–758 (2019)Cite this article

Summary

The aim of this research was to study the clinical features and microvascular complications risk factors of early-onset type 2 diabetes mellitus (T2DM). We analyzed the clinical data from 1421 T2DM inpatients at Wuhan Union Hospital. Subjects were divided into early-onset T2DM group (diagnostic age <40 years) and late-onset T2DM group (diagnostic age >40 years). All subjects underwent a standardized assessment of microvascular complications. Data were compared with independent-samples t test or Chi-square test. Multiple logistic regression was used to determine the risk factors of microvascular complications. Patients with early-onset T2DM were more inclined to have a lower systolic blood pressure (SBP), a longer duration of diabetes and higher levels of body mass index (BMI), uric acid (UA), fasting plasma glucose (FPG), total cholesterol (TC)- triglyceride (TG) and glycosylated hemoglobin (HbA1c) than those with late-onset T2DM (P<0.05). The prevalence of diabetic retinopathy (DR) was significantly higher and that of diabetic peripheral neuropathy (DPN) was significantly lower in early-onset group than in late-onset group (P<0.05). For DN, UA was an independent risk factor in early-onset T2DM. SBP and TG were independent risk factors in late-onset T2DM. For DR, duration of diabetes and SBP were independent risk factors in early-onset T2DM. Duration of diabetes, SBP and HbA1c were independent risk factors in late-onset T2DM. This study demonstrated that the clinical characteristics of early-onset T2DM were metabolic disorders, including glucose metabolism, lipid metabolism and amino acid metabolism. Early-onset T2DM was more likely to be associated with DR. The potential pathogenesis of early and late-onset T2DM might be different. The management of metabolic risk factors especially HbA1c, SBP, TG and UA is advised to be performed in the early stage of diabetes.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China. N Engl J Med, 2010,362(12):1090–1101

    CAS  Article  Google Scholar 

  2. Wang L, Gao P, Zhang M, et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013. JAMA, 2017,317(24):2515–2523

    Article  Google Scholar 

  3. Zou XT, Zhou XH, Ji LN, et al. The characteristics of newly diagnosed adult early-onset diabetes: a population-based cross-sectional study. Sci Rep, 2017, 7:46534

    CAS  Article  Google Scholar 

  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(9):1522–1527

    CAS  Article  Google Scholar 

  5. Li L, Ji LN, Guo XH, et al. Prevalence of microvascular diseases among tertiary care Chinese with early versus late onset of type 2 diabetes. J Diabetes Complications, 2015,29(1):32–37

    Article  Google Scholar 

  6. Song SH, Hardisty CA. Early onset type 2 diabetes mellitus: a harbinger for complications in later years—clinical observation from a secondary care cohort. Q J Med, 2009,102(11):799–806

    CAS  Article  Google Scholar 

  7. Chan JC, Lau ES, Luk AO, et al. Premature Mortality and Comorbidities in Young-onset Diabetes: A 7-Year Prospective Analysis. Am J Med, 2014,127(7):616–624

    Article  Google Scholar 

  8. Song SH. Emerging type 2 diabetes in young adults. Adv Exp Med Biol, 2012,771:51–61

    Article  Google Scholar 

  9. Luk AOY, Lau ESH, So WY, et al. Prospective study on the incidences of cardiovascular-renal complications in Chinese patients with young-onset type 1 and type 2 diabetes. Diabetes Care, 2014,37(1):149–157

    CAS  Article  Google Scholar 

  10. Yeung RO, Zhang Y, Luk A, et al. Metabolic profiles and treatment gaps in young-onset type 2 diabetes in Asia (the JADE programme): a cross-sectional study of a prospective cohort. Lancet Diabetes Endocrinol, 2014,2(12):935–943

    CAS  Article  Google Scholar 

  11. Chan JC, Cho NH, Tajima N, et al. Diabetes in the western pacific region-past, present and future. Diabetes Res Clin Pract, 2014,103(2):244–255

    Article  Google Scholar 

  12. Reis JP, Hankinson AL, Loria CM, et al. Duration of abdominal obesity beginning in young adulthood and incident diabetes through middle age: The CARDIA study. Diabetes Care, 2013,36(5):1241–1247

    CAS  Article  Google Scholar 

  13. Huo X, Gao L, Guo L, et al. Risk of non-fatal cardiovascular diseases in early-onset versus late-onset type 2 diabetes in China: a cross-sectional study. Lancet Diabetes Endocrinol, 2016,4(2):115–124

    Article  Google Scholar 

  14. Ma RC, Chan JC. Type 2 diabetes in East Asians: similarities and differences with populations in Europe and the United States. Ann N Y Acad Sci, 2013,1281:64–91

    Article  Google Scholar 

  15. Lerman-Garber I, Aguilar-Salinas C, Tusié-Luna T, et al. Early-onset type 2 diabetes mellitus. The experience from a third level medical institution. Gac Med Mex, 2010,146(3):179–184

    PubMed  Google Scholar 

  16. Gungor N, Arslanian S. Progressive beta cell failure in type 2 diabetes mellitus of youth. J Pediatr, 2004,144(5):656–659

    CAS  Article  Google Scholar 

  17. Irving R, Tusié-Luna MT, Mills J, et al. Early onset type 2 diabetes in Jamaica and in Mexico. Opportunities derived from an interethnic study. Rev Invest Clin, 2011,63(2):198–209

    PubMed  Google Scholar 

  18. Chuang LM, Soegondo S, Soewondo P, et al. Comparisons of the outcomes on control, type of management and complications status in early onset and late onset type 2 diabetes in Asia. Diabetes Res Clin Pract, 2006,71(2):146–155

    Article  Google Scholar 

  19. Pradeepa R, Anjana RM, Unnikrishnan R, et al. Risk factors for microvascular complications of diabetes among South Indian subjects with type 2 diabetes—the Chennai Urban Rural Epidemiology Study (CURES) Eye Study-5. Diabetes Technol Ther, 2010,12(10):755–761

    CAS  Article  Google Scholar 

  20. Gunathilake W, Song S, Sridharan S, et al. Cardiovascular and metabolic risk profiles in young and old patients with type 2 diabetes. QJM, 2010,103(11):881–884

    CAS  Article  Google Scholar 

  21. Hu XX, Gao LL, Guo LX, et al. Risk of non-fatal cardiovascular diseases in early-onset versus late-onset type 2 diabetes in China: a cross-sectional study. Lancet Diabetes Endocrinol, 2016,4 (2):115–124

    Article  Google Scholar 

  22. LeRoith D, Fonseca V, Vinik A. Metabolic memory in diabetes-focus on insulin. Diabetes Metab Res Rev, 2005,21(2):85–90

    CAS  Article  Google Scholar 

  23. Agrawal RP, Sharma P, Pal M, et al. Magnitude of dyslipedemia and its association with micro and macro vascular complications in type 2 diabetes: a hospital based study from Bikaner (Northwest India). Diabetes Res Clin Pract, 2006,73(2):211–214

    CAS  Article  Google Scholar 

  24. Hinder LM, Vivekanandan-Giri A, McLean LL, et al. Decreased glycolytic and tricarboxylic acid cycle intermediates coincide with peripheral nervous system oxidative stress in a murine model of type 2 diabetes. J Endocrinol, 2013,216(1):1–11

    CAS  Article  Google Scholar 

Download references

Author information

Author notes

  1. Both authors contributed equally to this work.

Affiliations

  1. Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Jia-xin Huang

  2. Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Jia-xin Huang, Yun-fei Liao & Yu-ming Li

Authors
  1. Jia-xin Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yun-fei Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yu-ming Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yu-ming Li.

Additional information

Conflict of Interest Statement

No conflict of interest exits in the submission of this manuscript, which is approved by all authors for publication. I would like to declare on behalf of my co-authors that the work described was original research that has not been published previously, and not under consideration for publication elsewhere, in whole or in part. All authors agree to authorize the global copyright of the thesis to Current Medical Science magazine.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Huang, Jx., Liao, Yf. & Li, Ym. Clinical Features and Microvascular Complications Risk Factors of Early-onset Type 2 Diabetes Mellitus. CURR MED SCI 39, 754–758 (2019). https://doi.org/10.1007/s11596-019-2102-7

Download citation

  • Received:

  • Revised:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11596-019-2102-7

Key words

  • early-onset type 2 diabetes mellitus
  • diabetic microvascular complication
  • diabetic nephropathy
  • diabetic retinopathy
  • diabetic peripheral neuropathy