Microalbuminuria and retinopathy in adolescents and young adults with type 1 and type 2 diabetes

Abstract

Aim: To estimate the occurrence of complications related to early-onset type 2 diabetes compared with type 1 diabetes. Methods: All individuals registered in the Swedish Pediatric Quality Diabetes Register and the Swedish National Diabetes Register with type 2 diabetes diagnosis at 10 to 25 years of age between 1996 and 2014 (n = 1413) were included. As controls, individuals with type 1 diabetes were randomly selected from the same registers and were matched for age, sex, and year-of-onset (n = 3748). Results: Of the adolescents with type 2 diabetes in the pediatric register, 7.7% had microalbuminuria and 24.6% had signs of retinopathy 5 years after diagnosis, whereas the adolescents with type 1 diabetes 3.8% had microalbuminuria and 19.2% had retinopathy. Among the young adults with type 2 diabetes from the adult diabetes register 10 years after diagnosis 15.2% had microalbuminuria and 39.7% retinopathy, whereas the young adults with type 1 diabetes 4.8% had microalbuminuria and 43.8% retinopathy. After adjustment for established risk factors measured over time in the whole combined cohort, individuals with type 2 diabetes had significantly higher risk of microalbuminuria with a hazard ratio (HR) of 3.32 (95% confidence interval, CI 2.86-3.85, P < .001), and retinopathy with a HR of 1.17 (95% CI 1.06-1.30, P 0.04). Conclusions: The prevalence of complications and comorbidities was higher among those with type 2 diabetes compared with type 1 diabetes, although prevalent in both groups. Early monitoring and more active treatment of type 2 diabetes in young individuals is required.

Protein-conformational diseases in childhood: Naturally-occurring hIAPP amyloid-oligomers and early β-cell damage in obesity and diabetes

“…The prevalence of childhood obesity and diabetes is increasing in the world [44]. The large variations of prediabetes and DM in several countries is a challenge for the healthcare system revealing that obesity and DM are catastrophic and harrowing diseases [3,27,44].…”

“…The prevalence of childhood obesity and diabetes is increasing in the world [44]. The large variations of prediabetes and DM in several countries is a challenge for the healthcare system revealing that obesity and DM are catastrophic and harrowing diseases [3,27,44]. By using real patient´s samples we began to unravelling the role of RIAO and we are advancing toward the novel diagnostic tools, prevention strategies and novel therapeutic targets [9,20,30].…”

Pediatric obesity—Long‐term consequences and effect of weight loss

“…Moreover, early-onset T2D, that is, in adolescence and young adulthood, is a much more severe disease than T1D diagnosed in the same age range. Diabetes complications such as nephropathy, retinopathy, and neuropathy come earlier and more frequently and together this results in a much higher mortality rate [85,[89][90][91]. Further, youths with T2D have a more deteriorated fluid cognition than youths with T1D, but the association seems to be mediated by obesity and depression [92].…”

“…T2D in children and adolescents was extremely rare before the present obesity epidemic, that is, only a few decades ago. The prevalence of prediabetes and diabetes in the pediatric obesity population varies greatly across countries and ethnicities but an increase is generally observed [ 81 , 82 , 83 , 84 , 85 ].…”

Difference in Insulin Resistance Assessment between European Union and Non-European Union Obesity Treatment Centers (ESPE Obesity Working Group Insulin Resistance Project)

“…It is well known that impaired insulin sensitivity increases the risk of developing T2DM and cardiovascular disease [6]. The link between insulin resistance (IR), impaired adipocytokine concentrations, and clinical symptoms in obese children has been well-documented [7][8][9].…”