Type 2 diabetes in younger adults: Clinical characteristics, diabetes-related complications and management of risk factors

Aim: To describe the clinical characteristics and risk factors of adults <35 years with type 2 diabetes (T2DM). Methods: Observational study of 185 younger adults attending a specialist diabetes clinic. Results: In this cohort 65% were female, 51% Caucasian, 43% South Asian. Characteristics at presentation: age 24 +/- 5.5 years, EMI 33 +/- 7.6 kg/m(2) and HbA1c 9.0%+/- 2.3. Follow up of 3.2 +/- 2.8 years with a diabetes duration of 4.5 +/- 3.6 years. HbA1c had improved compared with diagnosis (8.3 +/- 2.2% vs. 9.0%+/- 2.3%, p < 0.0001), but 63% still had an HbA1c > 7%. Oral anti-diabetic drugs were used in 72%, insulin alone in 19% and both in 26%. 41% had a BP >= 140/80 mmHg, 78% total cholesterol >4 mmol/l, 63% LDL >2 mmol/l, 56% triglycerides >1.7 mmol/l. From diagnosis only the cholesterol and LDL improved significantly, with a modest increase in primary prevention therapy (statin 12-26%, p < 0.0001, anti-hypertensives 16-29%, p < 0.0001, aspirin 8-12%, p = 0.18). 13% had retinopathy, 21% microalbuminuria. 46% had not been reviewed within the past year. Conclusions: This group represents an extreme phenotype with a high prevalence of insufficiently treated metabolic risk factors. There is need for tailored management strategies to engage and aggressively manage this high-risk group. (C) 2010 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.