Clinical research studyPremature Mortality and Comorbidities in Young-onset Diabetes: A 7-Year Prospective Analysis
Section snippets
Patients
The Prince of Wales Hospital is the teaching hospital of the Chinese University of Hong Kong and serves a catchment of 1.2 million, representing one sixth of the population in Hong Kong. The Hong Kong Diabetes Registry, established since 1995 as a quality improvement program, consecutively enrolled patients who were referred to the hospital for comprehensive assessment of metabolic control and diabetes complications. Referral sources included regional public community clinics, hospital-based
Baseline Patient Characteristics
Among 10,129 enrolled patients, 374 with type 1 diabetes, 38 with unknown type of diabetes, and 211 with non-Chinese ethnicity were excluded. In the remaining 9506 patients with type 2 diabetes, 2066 (21.3%) were diagnosed before the age of 40 years: 87 (0.9%) before the age of 20 years, 392 (4.0%) between the age of 20 to 29 years, and 1587 (16.3%) between the age of 30 to 39 years. There was a female preponderance in the young-onset group who were more likely to have positive family history,
Discussion
Despite the increasing prevalence of young-onset type 2 diabetes worldwide,11 there are relatively few reports on the natural history of this form of diabetes.4, 5, 12, 13 To the best of our knowledge, this is the largest prospective cohort of patients with young-onset diabetes, which accounted for 20% of the entire cohort. Despite being younger by 20 years, the young-onset group had similar or worse risk profiles than the late-onset group. With a mean age of 40 years and mean disease duration
Conclusions
In this large prospective cohort, 1 in 5 patients had young-onset diabetes characterized by strong family history and suboptimal risk factor control. Given the long disease duration faced by these patients, their lifetime risk for complications becomes considerably higher than in the late-onset group given the same age. An integrated program combining detection, treatment, and prevention is urgently needed to monitor disease trend, improve care, and evaluate the cost-effectiveness of
Acknowledgments
The authors thank all the patients for being part of this prospective cohort. Special thanks are extended to our medical and nursing staff at the Chinese University of Hong Kong, Prince of Wales Hospital Diabetes and Endocrine Centre, an International Diabetes Federation Centre of Education.
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Funding: The study is partially supported by the Hong Kong Foundation for Research and Development and Liao Wun Yuk Memorial Diabetes Research Fund of the Chinese University of Hong Kong.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.