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Comparison of clinical features, complication profile, and achievement of guideline targets in early- and late-onset type 2 diabetes patients from North India

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Introduction

The prevalence of diabetes in young people is rising in India. The risk factors are high body mass index, lack of physical activity, and a positive family history. Young patients with type 2 diabetes mellitus are at a higher risk of longer disease duration and enhanced risk for chronic complications. We have studied the difference between early- and late-onset type 2 diabetes mellitus with respect to various glycemic and non-glycemic parameters.

Material and methods

This is an observational cross-sectional study conducted from November 2018 to October 2019. A total of 5142 patients were included in the study. The demographic, anthropometric, clinical, and biochemical information was obtained from the record of the patients.

Results

The number of patients diagnosed before 40 years of age was 1574 and 3568 patients after 40 years of age. There was female preponderance, 75.7% of the study subjects were from the urban area, and 60% had an income of < 2 lakh rupees per annum. Two-third (77%) of the patients were either overweight or obese. Significantly higher proportion of patients achieved glycemic and blood pressure targets in the early-onset type 2 diabetes mellitus group. The younger group had higher weight and body mass index, strong family history of diabetes, and more severe dyslipidemia. The comorbid conditions were significantly higher in the older age group.

Conclusion

Our study has revealed that about one-third of type 2 diabetes mellitus patients are diagnosed before 40 years of age. The younger patients are more obese. Two-third (73%) of these patients have uncontrolled diabetes.

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References

  1. India State-Level Disease Burden Initiative Diabetes Collaborators. The increasing burden of diabetes and variations among the states of India: the Global Burden of Disease Study 1990–2016. Lancet Glob Health. 2018;6(12):e1352–62.

    Article  Google Scholar 

  2. Kim KS, Oh HJ, Kim JW, Lee YK, Kim SK, Park SW, et al. The clinical characteristics of the newly diagnosed early onset (< 40 years old) diabetes in outpatients’ clinic. Korean Diabetes J. 2010;34:119–25.

    Article  Google Scholar 

  3. Breton MC, Guénette L, Amiche MA, Kayibanda JF, Grégoire JP, Moisan J. Burden of diabetes on the ability to work: a systematic review. Diabetes Care. 2013;36(3):740–9.

    Article  Google Scholar 

  4. International Diabetes Federation. Diabetes Atlas. 3rd ed. Brussels: International Diabetes Federation; 2006. http://www.diabetesatlas.org/resources/previous-editions.html. Accessed 1 July 2020

    Google Scholar 

  5. International Diabetes Federation. IDF Diabetes Atlas. 6th ed. Brussels: International Diabetes Federation; 2013. http://www.diabetesatlas.org/resources/previous-editions.html. Accessed 1 April 2020

    Google Scholar 

  6. Holden SH, Barnett AH, Peters JR, Jenkins-Jones S, Poole CD, Morgan CL, et al. The incidence of type 2 diabetes in the United Kingdom from 1991 to 2010. Diabetes Obes Metab. 2013;15:844–52.

    Article  CAS  Google Scholar 

  7. Bolen S, Feldman L, Vassy J, Wilson L, Yeh HC, Marinopoulos S, et al. Systematic review: comparative effectiveness and safety of oral medications for type 2 diabetes mellitus. Ann Intern Med. 2007;147:386–99.

    Article  Google Scholar 

  8. Ashraf H, Ahmad J. Cardiovascular outcome trials in type 2 diabetes: a critical analysis. Diabetes Metab Syndr. 2019;13:300–5.

    Article  Google Scholar 

  9. Wexler DJ, Porneala B, Chang Y, Huang ES, Huffman JC, Grant RW. Diabetes differentially affects depression and self-rated health by age in the U.S. Diabetes Care. 2012;35:1575–7.

    Article  Google Scholar 

  10. Sattar N, Rawshani A, Franzén S, Svensson AM, Rosengren A, Rosengren A, et al. Age at diagnosis of type 2 diabetes mellitus and associations with cardiovascular and mortality risks. Circulation. 2019;139:2228–37.

    Article  Google Scholar 

  11. Ke C, Lau E, Shah BR, Stukel TA, Ma RC, So WY, et al. Excess burden of mental illness and hospitalization in young-onset type 2 diabetes: a population-based cohort study. Ann Intern Med. 2019;170:145–54.

    Article  Google Scholar 

  12. Association AD. 1. Improving care and promoting health in populations: standards of medical care in diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S7–S13.

    Article  Google Scholar 

  13. Lascar N, Brown J, Pattison H, Barnett AH, Bailey CJ, Bellary S. Type 2 diabetes in adolescents and young adults. Lancet Diabetes Endocrinol. 2018;6:69–80.

    Article  Google Scholar 

  14. Misra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS, Chadha D, et al. Concensus Group. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India. 2009 Feb;57:163–70.

    CAS  PubMed  Google Scholar 

  15. Ashraf H, Laway BA, Afroze D, Wani AI. Evaluation of proinflammatory cytokines in obese vs non-obese patients with metabolic syndrome. Indian J Endocrinol Metab. 2018;22:751–6.

    Article  CAS  Google Scholar 

  16. Sahoo SK, Zaidi G, Vipin VP, Chapla A, Thomas N, Yu L, et al. Heterogeneity in the aetiology of diabetes mellitus in young adults: a prospective study from north India. Indian J Med Res. 2019;149:479–88.

    Article  CAS  Google Scholar 

  17. Mohan V, Pradeepa R. Epidemiology of diabetes in different regions of India. Health Adm. 2009;22:1–18.

    Google Scholar 

  18. Misra A, Pandey RM, Devi JR, Sharma R, Vikram NK, Khanna N. High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in northern India. Int J Obes Relat Metab Disord. 2001;25:1722–9.

    Article  CAS  Google Scholar 

  19. Beigh SH, Jain S. Prevalence of metabolic syndrome and gender differences. Bioinformation. 2012;8:613–6.

    Article  Google Scholar 

  20. Shobhana R, Rao PR, Lavanya A, Vijay V, Ramachandran A. Cost burden to diabetic patients with foot complications–a study from southern India. J Assoc Physicians India. 2000;48:1147–50.

    CAS  PubMed  Google Scholar 

  21. Raheja BS, Kapur A, Bhoraskar A, Sathe SR, Jorgensen LN, Moorthi SR, et al. DiabCare Asia--India Study: diabetes care in India--current status. J Assoc Physicians India. 2001;49:717–22.

    CAS  PubMed  Google Scholar 

  22. Ahmad J, Zubair M, Malik N, Zephy D, Raghav A. Glycemic and non-glycemic targets in younger and older North Indian subjects with type 2 diabetes in a tertiary care hospital: a 10 year’s retrospective data analysis. Diabetes Metab Syndr. 2016;10:S130–4.

    Article  Google Scholar 

  23. Ramachandran A, Snehalatha C, Satyavani K, Latha E, Sasikala R, Vijay V. Prevalence of vascular complications and their risk factors in type 2 diabetes. J Assoc Physicians India. 1999;47:1152–6.

    CAS  PubMed  Google Scholar 

  24. Dutta A, Naorem S, Singh P, Wangjam K. Prevalence of peripheral neuropathy in newly diagnosed type 2 diabetics. Int J Diabetes Dev Ctries. 2005;25:30–3.

    Article  Google Scholar 

  25. Dart AB, Sellers EA, Martens PJ, Rigatto C, Brownell MD, Dean HJ. High burden of kidney disease in youth-onset type 2 diabetes. Diabetes Care. 2012;35:1265–71.

    Article  Google Scholar 

  26. Song SH, Gray TA. Early-onset type 2 diabetes: high risk for premature diabetic retinopathy. Diabetes Res Clin Pract. 2011;94:207–11.

    Article  Google Scholar 

  27. Mayer-Davis EJ, Lawrence JM, Dabelea D, Divers J, Isom S, Dolan L, et al. SEARCH for diabetes in youth study. Incidence trends of type 1 and type 2 diabetes among youths, 2002-2012. N Engl J Med. 2017;376:1419–29.

    Article  Google Scholar 

  28. Nizam S, Khalequzzaman M, Yatsuya H, Khanam PA, Sayeed MA, Naito H, et al. Incidence of young onset insulin-requiring diabetes mellitus among 18- to 30-year-olds in Dhaka, Bangladesh (1994-2003). Nagoya J Med Sci. 2012;74:149–56.

    PubMed  PubMed Central  Google Scholar 

  29. Tulloch-Reid MK, Boyne MS, Smikle MF, Choo-Kang EG, Parkes RH, Wright-Pascoe RA, et al. Clinical and laboratory features of youth onset type 2 diabetes in Jamaica. West Indian Med J. 2010;59:131–8.

    CAS  PubMed  Google Scholar 

  30. Joham AE, Ranasinha S, Zoungas S, Moran L, Teede HJ. Gestational diabetes and type 2 diabetes in reproductive-aged women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2014;99:e447–52.

    Article  CAS  Google Scholar 

  31. Steyn NP, Mann J, Bennett PH, Temple N, Zimmet P, Tuomilehto J, et al. Diet, nutrition and the prevention of type 2 diabetes. Public Health Nutr. 2004;7(1A):147–65.

    Article  CAS  Google Scholar 

  32. Molyneaux L, Constantino M, Yue D. Strong family history predicts a younger age of onset for subjects diagnosed with type 2 diabetes. Diabetes Obes Metab. 2004;6:187–94.

    Article  CAS  Google Scholar 

  33. Jali MV, Kambar S, Jali SM, Gowda S. Familial early onset of type-2 diabetes mellitus and its complications. N Am J Med Sci. 2009;1:377–80.

    PubMed  PubMed Central  Google Scholar 

  34. Katulanda GW, Katulanda P, Adler AI, Peiris SR, Draisey I, Wijeratne S, et al. Apolipoproteins in diabetes dyslipidaemia in South Asians with young adult-onset diabetes: distribution, associations and patterns. Ann Clin Biochem. 2010;47(Pt 1):29–34.

    Article  CAS  Google Scholar 

  35. Yeung RO, Zhang Y, Luk A, Yang W, Sobrepena L, Yoon KH, 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;2:935–43.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Rajiv Gandhi Centre for Diabetes and Endocrinology, Aligarh Muslim University, Aligarh, UP, India

    Hamid Ashraf

  2. Department of Physiology, Aligarh Muslim University, Aligarh, UP, India

    Ahmad Faraz

  3. Faculty of Medicine, Rajiv Gandhi Centre for Diabetes and Endocrinology, Aligarh Muslim University, Aligarh, UP, India

    Jamal Ahmad

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  1. Hamid Ashraf
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  2. Ahmad Faraz
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  3. Jamal Ahmad
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Correspondence to Hamid Ashraf.

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All the three authors declare that they do not have any conflict of interest.

Research involving human participants and/or animals

Yes.

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Approval was obtained from the institutional ethics committee. The procedures used in this study adhered to the tenets of the Declaration of Helsinki. Informed consent was obtained from all the individuals who participated in the study.

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Ashraf, H., Faraz, A. & Ahmad, J. Comparison of clinical features, complication profile, and achievement of guideline targets in early- and late-onset type 2 diabetes patients from North India. Int J Diabetes Dev Ctries 41, 396–403 (2021). https://doi.org/10.1007/s13410-020-00905-5

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