diagnosis

Younger people with type 2 diabetes not getting the care they need

by Barbara Hewitt on December 15, 2017

Younger people newly diagnosed with type 2 diabetes are hit hard by the disease and healthcare programmes are not prepared for the kind of problem they may face, according to new research.

In particular people aged under 45 who develop the conditions are more likely to develop cardiovascular disease or eye and kidney problems than in elderly newly diagnosed patients, the researchers from Aarhus University in Denmark have found.

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They say that the common view of type 2 diabetes as an old person’s disease is becoming seriously outdated as the number of younger people being diagnosed is rising and health systems are not prepared.

The study says that younger people with type 2 diabetes have special needs for intensive treatment and support, which they do not receive sufficiently. Younger type 2 diabetics are more overweight, have poorer controlled blood sugar levels, higher cholesterol levels and almost the same presence of hypertension.

The study looked at 5,115 people who have received a diagnosis with type 2 diabetes within two years of which 516 were aged under 45. Some 20% of the younger patients had early signs of damage to the kidneys, while 7% showed signs of eye problems.

Seeing early signs of diabetes complications among young patients is very serious, according to researcher Anne Bo, a master of science in public health science from Aarhus University who is undertaking the research as part of her PhD project.

‘When patients are already affected by type 2 diabetes at such a young age, the damage can develop into blindness, kidney failure or life threatening cardiovascular diseases, as they must live with the disease for decades,’ she said.

‘The study therefore provides vital knowledge about the group’s risk factors, which means that the healthcare system can initiate better and more targeted prevention. We know from previous studies that persons with type 2 diabetes who receive proper treatment have a lower risk of death from heart disease. Consequently, early intervention is so important,’ she added.

She explained that younger people are generally receiving too little treatment. They receive far less preventive treatment with medicine such as antihypertensive medicine, lipid lowering medicine and anticoagulants.

In addition, they have stated that they exercise less and smoke more than the elderly patients. ‘This points towards a need to rethink the way the healthcare sector organises type 2 diabetes treatment, and not least, how the younger type 2 diabetes patients are met by healthcare professionals,’ Anne Bo said.

Patients’ own experiences which were recorded in connection with the study show that some were diagnosed at a 15-minute consultation with their GP and not given enough information. ‘They would go home and Google more information about living with diabetes, often finding some harsh descriptions. Receiving such a serious diagnosis is a big shock and it is very daunting to be sent home after only being told you should come back in three months for a check-up,’ Anne Bo pointed out.

‘Many patients feel a lot of guilt and shame about getting type 2 diabetes, which is related to lifestyle. They feel very alone when it comes to tackling a disease that is commonly associated with elderly people. Also, the GP’s communication is most often adapted to the elderly. This can also contribute to the explanation of the younger patients’ proportionately poorer health,’ she added.

Helle Terkildsen Maindal, professor of health promotion at Aarhus University, believes that too often young people blame themselves.‘Obesity and inactivity help trigger diabetes in people who are perhaps hereditarily predisposed for it or have a higher genetically determined risk of diabetes. Consequently, eating habits and exercise play a big role in prevention,’ she said.

‘But it is a disease that is to a large extent contingent on the society we live in and its living conditions and habits. It is not ignorance or laziness that leads to 50% of people aged 35 to 44 in Denmark being overweight and thus at risk of developing type 2 diabetes. It is about societal structures, working conditions and things like our exercise and eating habits,’ she explained.

‘On top of this, there is a healthcare system which is not designed appropriately for this group. For example, we know that the age group finds it difficult to come to check-ups because they take place in the middle of working hours,’ she added.

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