Association of type 1 diabetes vs type 2 diabetes diagnosed during childhood and adolescence with complications during teenage years and young adulthood

SEARCH for Diabetes in Youth Research Group

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

IMPORTANCE The burden and determinants of complications and comorbidities in contemporary youth-onset diabetes are unknown. OBJECTIVE To determine the prevalence of and risk factors for complications related to type 1 diabetes vs type 2 diabetes among teenagers and young adults who had been diagnosed with diabetes during childhood and adolescence. DESIGN, SETTING, AND PARTICIPANTS Observational study from 2002 to 2015 in 5 US locations, including 2018 participants with type 1 and type 2 diabetes diagnosed at younger than 20 years, with single outcome measures between 2011 and 2015. EXPOSURES Type 1 and type 2 diabetes and established risk factors (hemoglobin A1c level, body mass index, waist-height ratio, and mean arterial blood pressure). MAIN OUTCOMES AND MEASURES Diabetic kidney disease, retinopathy, peripheral neuropathy, cardiovascular autonomic neuropathy, arterial stiffness, and hypertension. RESULTS Of 2018 participants, 1746 had type 1 diabetes (mean age, 17.9 years [SD 4.1]; 1327 non-Hispanic white [76.0%]; 867 female patients [49.7%]), and 272 had type 2 (mean age, 22.1 years [SD 3.5]; 72 non-Hispanic white [26.5%]; 181 female patients [66.5%]). Mean diabetes duration was 7.9 years (both groups). Patients with type 2 diabetes vs those with type 1 had higher age-adjusted prevalence of all measured complications except cardiovascular autonomic neuropathy. After adjustment for established risk factors measured over time, participants with type 2 diabetes vs those with type 1 had significantly higher odds of diabetic kidney disease, retinopathy, and peripheral neuropathy but no significant difference in the odds of arterial stiffness and hypertension. CONCLUSIONS AND RELEVANCE Among teenagers and young adults who had been diagnosed with diabetes during childhood or adolescence, the prevalence of complications and comorbidities was higher among those with type 2 diabetes compared with type 1, but frequent in both groups. These findings support early monitoring of youth with diabetes for development of complications.

Original languageEnglish (US)
Pages (from-to)825-835
Number of pages11
JournalJAMA - Journal of the American Medical Association
Volume317
Issue number8
DOIs
StatePublished - Feb 28 2017
Externally publishedYes

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Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Vascular Stiffness
Diabetic Nephropathies
Peripheral Nervous System Diseases
Comorbidity
Young Adult
Arterial Pressure
Hypertension
Diabetes Complications
Observational Studies
Hemoglobins
Body Mass Index
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Association of type 1 diabetes vs type 2 diabetes diagnosed during childhood and adolescence with complications during teenage years and young adulthood. / SEARCH for Diabetes in Youth Research Group.

In: JAMA - Journal of the American Medical Association, Vol. 317, No. 8, 28.02.2017, p. 825-835.

Research output: Contribution to journalArticle

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abstract = "IMPORTANCE The burden and determinants of complications and comorbidities in contemporary youth-onset diabetes are unknown. OBJECTIVE To determine the prevalence of and risk factors for complications related to type 1 diabetes vs type 2 diabetes among teenagers and young adults who had been diagnosed with diabetes during childhood and adolescence. DESIGN, SETTING, AND PARTICIPANTS Observational study from 2002 to 2015 in 5 US locations, including 2018 participants with type 1 and type 2 diabetes diagnosed at younger than 20 years, with single outcome measures between 2011 and 2015. EXPOSURES Type 1 and type 2 diabetes and established risk factors (hemoglobin A1c level, body mass index, waist-height ratio, and mean arterial blood pressure). MAIN OUTCOMES AND MEASURES Diabetic kidney disease, retinopathy, peripheral neuropathy, cardiovascular autonomic neuropathy, arterial stiffness, and hypertension. RESULTS Of 2018 participants, 1746 had type 1 diabetes (mean age, 17.9 years [SD 4.1]; 1327 non-Hispanic white [76.0{\%}]; 867 female patients [49.7{\%}]), and 272 had type 2 (mean age, 22.1 years [SD 3.5]; 72 non-Hispanic white [26.5{\%}]; 181 female patients [66.5{\%}]). Mean diabetes duration was 7.9 years (both groups). Patients with type 2 diabetes vs those with type 1 had higher age-adjusted prevalence of all measured complications except cardiovascular autonomic neuropathy. After adjustment for established risk factors measured over time, participants with type 2 diabetes vs those with type 1 had significantly higher odds of diabetic kidney disease, retinopathy, and peripheral neuropathy but no significant difference in the odds of arterial stiffness and hypertension. CONCLUSIONS AND RELEVANCE Among teenagers and young adults who had been diagnosed with diabetes during childhood or adolescence, the prevalence of complications and comorbidities was higher among those with type 2 diabetes compared with type 1, but frequent in both groups. These findings support early monitoring of youth with diabetes for development of complications.",
author = "{SEARCH for Diabetes in Youth Research Group} and Dana Dabelea and Stafford, {Jeanette M.} and Mayer-Davis, {Elizabeth J.} and Ralph D'Agostino and Lawrence Dolan and Giuseppina Imperatore and Barbara Linder and Lawrence, {Jean M.} and Marcovina, {Santica M.} and Mottl, {Amy K.} and Black, {Mary Helen} and Rodica Pop-Busui and Sharon Saydah and Hamman, {Richard F.} and Catherine Pihoker and Corinna Koebnick and Kristi Reynolds and Kim Holmquist and Xia Li and Pettitt, {David J.} and Santa Barbara and Lisa Testaverde and Anna Bellatorre and Klingensmith, {Georgeanna J.} and Rewers, {Marian J.} and David Maahs and Paul Wadwa and Stephen Daniels and Greta Wilkening and Kahn, {Michael G.} and Bloch, {Clifford A.} and Kathy Love-Osborne and Standiford, {Debra A.} and Joan Thomas and James Amrhein and Bryce Nelson and Anwar Merchant and Liese, {Angela D.} and Malaka Jackson and Lisa Knight and Maryam Afkarian and Irl Hirsch and Liu, {Lenna L.} and John Neff and Grace Kim and Craig Taplin and Debika Nandi-Munshi and Joyce Yi-Frazier and Lina Merjaneh and Davene Wright",
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T1 - Association of type 1 diabetes vs type 2 diabetes diagnosed during childhood and adolescence with complications during teenage years and young adulthood

AU - SEARCH for Diabetes in Youth Research Group

AU - Dabelea, Dana

AU - Stafford, Jeanette M.

AU - Mayer-Davis, Elizabeth J.

AU - D'Agostino, Ralph

AU - Dolan, Lawrence

AU - Imperatore, Giuseppina

AU - Linder, Barbara

AU - Lawrence, Jean M.

AU - Marcovina, Santica M.

AU - Mottl, Amy K.

AU - Black, Mary Helen

AU - Pop-Busui, Rodica

AU - Saydah, Sharon

AU - Hamman, Richard F.

AU - Pihoker, Catherine

AU - Koebnick, Corinna

AU - Reynolds, Kristi

AU - Holmquist, Kim

AU - Li, Xia

AU - Pettitt, David J.

AU - Barbara, Santa

AU - Testaverde, Lisa

AU - Bellatorre, Anna

AU - Klingensmith, Georgeanna J.

AU - Rewers, Marian J.

AU - Maahs, David

AU - Wadwa, Paul

AU - Daniels, Stephen

AU - Wilkening, Greta

AU - Kahn, Michael G.

AU - Bloch, Clifford A.

AU - Love-Osborne, Kathy

AU - Standiford, Debra A.

AU - Thomas, Joan

AU - Amrhein, James

AU - Nelson, Bryce

AU - Merchant, Anwar

AU - Liese, Angela D.

AU - Jackson, Malaka

AU - Knight, Lisa

AU - Afkarian, Maryam

AU - Hirsch, Irl

AU - Liu, Lenna L.

AU - Neff, John

AU - Kim, Grace

AU - Taplin, Craig

AU - Nandi-Munshi, Debika

AU - Yi-Frazier, Joyce

AU - Merjaneh, Lina

AU - Wright, Davene

PY - 2017/2/28

Y1 - 2017/2/28

N2 - IMPORTANCE The burden and determinants of complications and comorbidities in contemporary youth-onset diabetes are unknown. OBJECTIVE To determine the prevalence of and risk factors for complications related to type 1 diabetes vs type 2 diabetes among teenagers and young adults who had been diagnosed with diabetes during childhood and adolescence. DESIGN, SETTING, AND PARTICIPANTS Observational study from 2002 to 2015 in 5 US locations, including 2018 participants with type 1 and type 2 diabetes diagnosed at younger than 20 years, with single outcome measures between 2011 and 2015. EXPOSURES Type 1 and type 2 diabetes and established risk factors (hemoglobin A1c level, body mass index, waist-height ratio, and mean arterial blood pressure). MAIN OUTCOMES AND MEASURES Diabetic kidney disease, retinopathy, peripheral neuropathy, cardiovascular autonomic neuropathy, arterial stiffness, and hypertension. RESULTS Of 2018 participants, 1746 had type 1 diabetes (mean age, 17.9 years [SD 4.1]; 1327 non-Hispanic white [76.0%]; 867 female patients [49.7%]), and 272 had type 2 (mean age, 22.1 years [SD 3.5]; 72 non-Hispanic white [26.5%]; 181 female patients [66.5%]). Mean diabetes duration was 7.9 years (both groups). Patients with type 2 diabetes vs those with type 1 had higher age-adjusted prevalence of all measured complications except cardiovascular autonomic neuropathy. After adjustment for established risk factors measured over time, participants with type 2 diabetes vs those with type 1 had significantly higher odds of diabetic kidney disease, retinopathy, and peripheral neuropathy but no significant difference in the odds of arterial stiffness and hypertension. CONCLUSIONS AND RELEVANCE Among teenagers and young adults who had been diagnosed with diabetes during childhood or adolescence, the prevalence of complications and comorbidities was higher among those with type 2 diabetes compared with type 1, but frequent in both groups. These findings support early monitoring of youth with diabetes for development of complications.

AB - IMPORTANCE The burden and determinants of complications and comorbidities in contemporary youth-onset diabetes are unknown. OBJECTIVE To determine the prevalence of and risk factors for complications related to type 1 diabetes vs type 2 diabetes among teenagers and young adults who had been diagnosed with diabetes during childhood and adolescence. DESIGN, SETTING, AND PARTICIPANTS Observational study from 2002 to 2015 in 5 US locations, including 2018 participants with type 1 and type 2 diabetes diagnosed at younger than 20 years, with single outcome measures between 2011 and 2015. EXPOSURES Type 1 and type 2 diabetes and established risk factors (hemoglobin A1c level, body mass index, waist-height ratio, and mean arterial blood pressure). MAIN OUTCOMES AND MEASURES Diabetic kidney disease, retinopathy, peripheral neuropathy, cardiovascular autonomic neuropathy, arterial stiffness, and hypertension. RESULTS Of 2018 participants, 1746 had type 1 diabetes (mean age, 17.9 years [SD 4.1]; 1327 non-Hispanic white [76.0%]; 867 female patients [49.7%]), and 272 had type 2 (mean age, 22.1 years [SD 3.5]; 72 non-Hispanic white [26.5%]; 181 female patients [66.5%]). Mean diabetes duration was 7.9 years (both groups). Patients with type 2 diabetes vs those with type 1 had higher age-adjusted prevalence of all measured complications except cardiovascular autonomic neuropathy. After adjustment for established risk factors measured over time, participants with type 2 diabetes vs those with type 1 had significantly higher odds of diabetic kidney disease, retinopathy, and peripheral neuropathy but no significant difference in the odds of arterial stiffness and hypertension. CONCLUSIONS AND RELEVANCE Among teenagers and young adults who had been diagnosed with diabetes during childhood or adolescence, the prevalence of complications and comorbidities was higher among those with type 2 diabetes compared with type 1, but frequent in both groups. These findings support early monitoring of youth with diabetes for development of complications.

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