Teenagers and young adults with type 2 diabetes develop common complications related to the condition more often than their peers with type 1 diabetes, new research has found.
In particular they develop kidney, nerve, and eye diseases as well as some risk factors for heart disease in the years shortly after diagnosis, according to work done in one of the largest studies of its kind in the United States.
Those taking part in the study included 1,746 with type 1 diabetes with an average age of 18 and 272 with type 2 diabetes and an average age of 22. All were diagnosed with diabetes before the age of 20 and had diabetes for an average of less than eight years.
Of those with type 2 diabetes nearly 20% developed a sign of kidney disease by the end of the study compared to about 6% of those with type 1 diabetes. Some 18% with type 2 diabetes developed nerve disease while only 9% with type 1 did.
Eye disease developed in 9% of those with type 2 diabetes and 6% of those with type 1 diabetes while measures for two risk factors for heart disease, hypertension and arterial stiffness, were greater for those with type 2 diabetes but close to equal for cardiovascular autonomic neuropathy.
Although young people with type 2 diabetes showed signs of complications more often in nearly every measure than their peers with type 1 diabetes, many in both groups developed complications.
‘There’s often the assumption that young people don’t develop complications from diabetes, but that’s just not true. We saw that young people with diabetes are developing signs of major complications in the prime of their lives,’ said Dr. Barbara Linder, a study author and senior advisor for childhood diabetes research at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
‘Particularly for youth with type 2, this research demonstrates the clear need to learn how to reduce or delay the debilitating complications of diabetes, itself a huge challenge for young people to manage,’ she added.
During the study the researchers looked at factors including glucose control, body mass index, waist to height ratio and blood pressure, but no factor could explain why people with type 2 diabetes developed more complications than their counterparts with type 1 diabetes.
By about the age of 21, about a third of participants with type 1 diabetes and about three quarters of participants with type 2 diabetes had at least one complication from diabetes or were at high risk for a complication.
‘This study highlights the need for early monitoring for development of complications among young people with diabetes. If young people can delay onset of these complications from diabetes by even a few years, that can ease their burden and lengthen their lives,’ said Dr. Sharon Saydah, senior scientist at CDC and an author of the paper.
The high burden of early complications in young people with diabetes requires additional research to clarify the underlying causes and to identify effective intervention strategies, according to Dr. Dana Dabelea, lead author and co-chair of the national SEARCH Study and professor of epidemiology at the Colorado School of Public Health at the University of Colorado.
‘It is extremely useful to have these estimates of the presence of complications in adolescents and young adults who are being treated with current therapies, especially because the complications are frequent. We need to make sure each risk factor is under the best control possible to reduce future problems,’ she added.
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