Characteristics and care of young people with type 2 diabetes included in the national diabetes audit datasets for England

Misra, Shivani; Holman, Naomi; Barron, Emma; Knighton, Peter; Warner, Justin; Kar, Partha; Young, Bob; Valabhji, Jonathan

doi:10.1111/dme.14940

Cited by 15 publications

(12 citation statements)

References 24 publications

(39 reference statements)

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“…In contrast, people of Asian ethnicity accounted for 20% (192,805/945,090) of type 2 diabetes in those aged 40-59 years and only 11% (180,355/1,574,585) of those aged 60-79 years. 35 Black individuals also showed higher proportions in those aged <16 years 13% (85/650) and aged 16-18 years 10% (95/910) compared to later years-7% (68,760/945,090) of those aged 40-49 years and 4% (56,710/1,574,585) of those aged 50-79 years.…”

Section: An Expanding Ethnically Diverse and Socioeconomically Depriv...mentioning

confidence: 87%

“…In English national data, for example, Asian ethnicity was recorded for 38% (245/650) of those under 16 years, 31% (280/910) of those aged 16–18 years and 31% (1865/8245) of those aged 26–39 years. In contrast, people of Asian ethnicity accounted for 20% (192,805/945,090) of type 2 diabetes in those aged 40–59 years and only 11% (180,355/1,574,585) of those aged 60–79 years 35 . Black individuals also showed higher proportions in those aged <16 years 13% (85/650) and aged 16–18 years 10% (95/910) compared to later years—7% (68,760/945,090) of those aged 40–49 years and 4% (56,710/1,574,585) of those aged 50–79 years.…”

Section: Current Evidence In Early‐onset Type 2 Diabatesmentioning

confidence: 94%

“…At a population level, the number of cases presenting in early adulthood (aged 18–39 years) accounts for a significantly larger proportion of the ‘early‐onset’ group than those under 18 years. In NDA data; of 122,780 individuals in England with type 2 diabetes currently aged <40 years, 650 (0.5%) were children under 16 years of age, 910 (0.7%) adolescents aged between 16 and 18 years, 8245 (6.7%) young adults between 19 and 25 years‐of‐age and 112,980 (92%) adults aged between 26 and 39 years 35 …”

Section: Current Evidence In Early‐onset Type 2 Diabatesmentioning

confidence: 99%

“…It is possible that current models of care in operation work less well for early‐onset type 2 diabetes than for later‐onset cases given the age‐related changes identified in the delivery of care processes and achievement of HbA 1c targets from NDA audit data 35 …”

Section: Is the Current Model Of Care Working?mentioning

confidence: 99%

“…In NDA data; of 122,780 individuals in England with type 2 diabetes currently aged <40 years, 650 (0.5%) were children under 16 years of age, 910 (0.7%) adolescents aged between 16 and 18 years, 8245 (6.7%) young adults between 19 and 25 years-of-age and 112,980 (92%) adults aged between 26 and 39 years. 35 In nearly all descriptions of cohorts of early-onset type 2 diabetes, Asian and black individuals are overrepresented. 28,33,36,37 In English national data, for example, Asian ethnicity was recorded for 38% (245/650) of those under 16 years, 31% (280/910) of those aged 16-18 years and 31% (1865/8245) of those aged 26-39 years.…”

Section: An Expanding Ethnically Diverse and Socioeconomically Depriv...mentioning

confidence: 99%

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Developing services to support the delivery of care to people with early‐onset type 2 diabetes

et al. 2022

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Early-onset type 2 diabetes occurring in childhood or early adulthood carries a significant excess burden of microvascular diabetes complications, cardiovascular disease and premature death, compared to later onset type 2 diabetes along with adverse pregnancy outcomes in women of child-bearing age. National audit data in England reveal that 122,780 individuals under the age of 40 years are currently living with type 2 diabetes, with an over-representation of people from minority ethnicities and those in the most socioeconomically deprived quintiles. A diagnosis of type 2 diabetes earlier in life poses some unique challenges to healthcare providers that are not routinely encountered when type 2 diabetes presents later. These include; (1) the need to ensure correct diabetes classification in an age group that carries a higher probability of other types of diabetes, (2) overcoming difficulties in engaging with individuals who are of working age or in fulltime education, (3) appreciating and addressing the lower attainment of diabetes treatment targets and (4) proactively supporting women of child-bearing age to optimise their future pregnancy outcomes through better preparation for pregnancy, including achieving optimum glycaemic control at the time of conception. Meanwhile, approaches to prevent type 2 diabetes in younger age groups are challenged by difficulties in identifying those at highest risk, by poorer attendance at lifestyle interventions to prevent or delay the onset of type 2 diabetes and by attenuation of associated weight loss in those that do attend. In this article, we discuss the importance of recognising and addressing the distinct challenges in delivering healthcare to those with early-onset type 2 diabetes, the greater challenges in preventing type 2 diabetes at younger ages, and key components of strategies that might address these challenges to drive improvements in pregnancy outcomes, microvascular and cardiovascular outcomes.

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Section: An Expanding Ethnically Diverse and Socioeconomically Depriv...mentioning

confidence: 87%

Section: Current Evidence In Early‐onset Type 2 Diabatesmentioning

confidence: 94%

Section: Current Evidence In Early‐onset Type 2 Diabatesmentioning

confidence: 99%

Section: Is the Current Model Of Care Working?mentioning

confidence: 99%

Section: An Expanding Ethnically Diverse and Socioeconomically Depriv...mentioning

confidence: 99%

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Developing services to support the delivery of care to people with early‐onset type 2 diabetes

et al. 2022

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Formative work for the LEGEND (Low EnerGy diEt iN adolescents with type 2 Diabetes and obesity) study: example of PPIE in research

Blake,

Law,

Procter

et al. 2024

Practical Diabetes

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This study used evidence‐based guidance to report on patient and public involvement and engagement (PPIE) activities that informed the design of a feasibility trial to explore the use of a low‐energy diet for children and young people (CYP) with type 2 diabetes. Overall, our PPIE work demonstrated the willingness of CYP to engage in these dietary interventions and the feasibility trial research processes. Engagement with stakeholders provided insights into factors influencing intervention participation and engagement, which will be considered in the design and implementation of subsequent trials.

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Association between age at diagnosis and all-cause mortality in type 2 diabetes: the Renal Insufficiency and Cardiovascular Events (RIACE) Italian Multicenter Study

Vitale,

Orsi,

Solini

et al. 2024

Acta Diabetol

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Aims It is unclear whether type 2 diabetes diagnosed in young adulthood is associated with increased severity than that occurring later in life beyond longer lifetime exposure to hyperglycemia. This study aimed at assessing the independent association of age at type 2 diabetes diagnosis with all-cause mortality. Methods This prospective cohort study enrolled 15,773 Caucasian patients with type 2 diabetes in 19 Italian centers in 2006–2008. Cardiometabolic risk profile and presence of complications and comorbidities were assessed at baseline and participants were stratified by quartiles of age at diabetes diagnosis. All-cause mortality was verified on 31 October 2015. Results Valid information on vital status was retrieved for 15,656 participants (99.3%). Patients in the lowest quartile had the longest diabetes duration, the worst glycemic control and the highest prevalence of insulin treatment, obesity, atherogenic dyslipidemia, and smoking habits. All complications were inversely associated with age at diabetes diagnosis after adjustment for age and sex, but not after further adjustment for diabetes duration. Percentages of death, Kaplan–Meier estimates, and unadjusted hazard ratios and mortality rates increased from the lowest to the highest quartile. In contrast, when adjusting for age and sex, participants falling in the lowest quartile, showed the highest mortality risk [hazard ratio 1.321 (95% confidence interval 1.196–1.460), P < 0.0001]. However, differences among quartiles disappeared after adjustment for diabetes duration, complications/comorbidities, or other cardiovascular risk factors. Conclusions Type 2 diabetes onset in young adulthood is associated with increased mortality that is mainly driven by longer diabetes duration favoring the development of complications. Trial registration: ClinicalTrials.gov, NCT00715481, retrospectively registered 15 July, 2008.

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Characteristics and care of young people with type 2 diabetes included in the national diabetes audit datasets for England

Cited by 15 publications

References 24 publications

Developing services to support the delivery of care to people with early‐onset type 2 diabetes

Developing services to support the delivery of care to people with early‐onset type 2 diabetes

Formative work for the LEGEND (Low EnerGy diEt iN adolescents with type 2 Diabetes and obesity) study: example of PPIE in research

Association between age at diagnosis and all-cause mortality in type 2 diabetes: the Renal Insufficiency and Cardiovascular Events (RIACE) Italian Multicenter Study

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