Natalie Nanayakkara1,2, Andrea J Curtis1, Stephane Heritier1, Adelle M Gadowski1, Meda E Pavkov3, Timothy Kenealy4, David R Owens5, Rebecca L Thomas5, Soon Song6, Jencia Wong7, Juliana C-N Chan8, Andrea O-Y Luk8, Giuseppe Penno9, Linong Ji10, Viswanathan Mohan11, Anandakumar Amutha11, Pedro Romero-Aroca12, Danijela Gasevic13,14, Dianna J Magliano1,2, Helena J Teede15, John Chalmers16, Sophia Zoungas17,18. 1. School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. 2. Baker Heart and Diabetes Institute, Melbourne, VIC, Australia. 3. Centers for Disease Control and Prevention, Division for Diabetes Translation, Atlanta, GA, USA. 4. Department of Medicine, University of Auckland, Auckland, New Zealand. 5. Diabetes Research Group, Swansea University Medical School, Swansea, Wales, UK. 6. Department of Diabetes, Northern General Hospital, Sheffield, UK. 7. Royal Prince Alfred Hospital, Camperdown, NSW, Australia. 8. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Shenzhen, People's Republic of China. 9. Diabetes and Metabolic Disease Section, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Pisana University of Pisa, Pisa, Italy. 10. Department of Endocrinology, Peking University People's Hospital, Xicheng District, Beijing, China. 11. Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, Chennai, India. 12. Hospital Universtario Sant Joan, Reus, Spain. 13. School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. danijela.gasevic@monash.edu. 14. Usher Institute, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, UK. danijela.gasevic@monash.edu. 15. Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia. 16. The George Institute for Global Health, Camperdown, NSW, Australia. 17. School Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. sophia.zoungas@monash.edu. 18. The George Institute for Global Health, Camperdown, NSW, Australia. sophia.zoungas@monash.edu.
Abstract
AIMS/HYPOTHESIS: Few studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise the risk of mortality, macrovascular complications and microvascular complications associated with age at diagnosis of type 2 diabetes. METHODS: Data were sourced from MEDLINE and All EBM (Evidence Based Medicine) databases from inception to July 2018. Observational studies, investigating the effect of age at diabetes diagnosis on macrovascular and microvascular diabetes complications in adults with type 2 diabetes were selected according to pre-specified criteria. Two investigators independently extracted data and evaluated all studies. If data were not reported in a comparable format, data were obtained from authors, presented as minimally adjusted ORs (and 95% CIs) per 1 year increase in age at diabetes diagnosis, adjusted for current age for each outcome of interest. The study protocol was recorded with PROSPERO International Prospective Register of Systematic Reviews (CRD42016043593). RESULTS: Data from 26 observational studies comprising 1,325,493 individuals from 30 countries were included. Random-effects meta-analyses with inverse variance weighting were used to obtain the pooled ORs. Age at diabetes diagnosis was inversely associated with risk of all-cause mortality and macrovascular and microvascular disease (all p < 0.001). Each 1 year increase in age at diabetes diagnosis was associated with a 4%, 3% and 5% decreased risk of all-cause mortality, macrovascular disease and microvascular disease, respectively, adjusted for current age. The effects were consistent for the individual components of the composite outcomes (all p < 0.001). CONCLUSIONS/ INTERPRETATION: Younger, rather than older, age at diabetes diagnosis was associated with higher risk of mortality and vascular disease. Early and sustained interventions to delay type 2 diabetes onset and improve blood glucose levels and cardiovascular risk profiles of those already diagnosed are essential to reduce morbidity and mortality. Graphical abstract.
AIMS/HYPOTHESIS: Few studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise the risk of mortality, macrovascular complications and microvascular complications associated with age at diagnosis of type 2 diabetes. METHODS: Data were sourced from MEDLINE and All EBM (Evidence Based Medicine) databases from inception to July 2018. Observational studies, investigating the effect of age at diabetes diagnosis on macrovascular and microvascular diabetes complications in adults with type 2 diabetes were selected according to pre-specified criteria. Two investigators independently extracted data and evaluated all studies. If data were not reported in a comparable format, data were obtained from authors, presented as minimally adjusted ORs (and 95% CIs) per 1 year increase in age at diabetes diagnosis, adjusted for current age for each outcome of interest. The study protocol was recorded with PROSPERO International Prospective Register of Systematic Reviews (CRD42016043593). RESULTS: Data from 26 observational studies comprising 1,325,493 individuals from 30 countries were included. Random-effects meta-analyses with inverse variance weighting were used to obtain the pooled ORs. Age at diabetes diagnosis was inversely associated with risk of all-cause mortality and macrovascular and microvascular disease (all p < 0.001). Each 1 year increase in age at diabetes diagnosis was associated with a 4%, 3% and 5% decreased risk of all-cause mortality, macrovascular disease and microvascular disease, respectively, adjusted for current age. The effects were consistent for the individual components of the composite outcomes (all p < 0.001). CONCLUSIONS/ INTERPRETATION: Younger, rather than older, age at diabetes diagnosis was associated with higher risk of mortality and vascular disease. Early and sustained interventions to delay type 2 diabetes onset and improve blood glucose levels and cardiovascular risk profiles of those already diagnosed are essential to reduce morbidity and mortality. Graphical abstract.
Entities:
Keywords:
Age factors; Age of onset; Diabetes; Diabetes complications; Diabetes mellitus, type 2; Disease progression; Meta-analysis; Prognosis; Systematic review
Authors: H Yokoyama; M Okudaira; T Otani; A Sato; J Miura; H Takaike; H Yamada; K Muto; Y Uchigata; Y Ohashi; Y Iwamoto Journal: Kidney Int Date: 2000-07 Impact factor: 10.612
Authors: Phil Zeitler; Kathryn Hirst; Laura Pyle; Barbara Linder; Kenneth Copeland; Silva Arslanian; Leona Cuttler; David M Nathan; Sherida Tollefsen; Denise Wilfley; Francine Kaufman Journal: N Engl J Med Date: 2012-04-29 Impact factor: 91.245
Authors: Meda E Pavkov; Peter H Bennett; William C Knowler; Jonathan Krakoff; Maurice L Sievers; Robert G Nelson Journal: JAMA Date: 2006-07-26 Impact factor: 56.272
Authors: Roseanne O Yeung; Yuying Zhang; Andrea Luk; Wenying Yang; Leorino Sobrepena; Kun-Ho Yoon; S R Aravind; Wayne Sheu; Thy Khue Nguyen; Risa Ozaki; Chaicharn Deerochanawong; Chiu Chi Tsang; Wing-Bun Chan; Eun Gyoung Hong; Trung Quan Do; Yu Cheung; Nicola Brown; Su Yen Goh; Ronald C Ma; Monojitketan Mukhopadhyay; Arvind Kumar Ojha; Shaibal Chakraborty; Alice P Kong; Winnie Lau; Weiping Jia; Wenhui Li; Xiaohui Guo; Rongwen Bian; Jianping Weng; Linong Ji; Mercedes Reyes-dela Rosa; Ronaldo M Toledo; Thep Himathongkam; Soon-Jib Yoo; C C Chow; Larry L T Ho; Lee-Ming Chuang; Greg Tutino; Peter C Tong; Wing-Yee So; Troels Wolthers; Gary Ko; Greg Lyubomirsky; Juliana C N Chan Journal: Lancet Diabetes Endocrinol Date: 2014-07-28 Impact factor: 32.069
Authors: Michael C Wang; Nilay S Shah; Mercedes R Carnethon; Matthew J O'Brien; Sadiya S Khan Journal: JAMA Intern Med Date: 2021-11-01 Impact factor: 44.409
Authors: Jean M Lawrence; Kristi Reynolds; Sharon H Saydah; Amy Mottl; Catherine Pihoker; Dana Dabelea; Lawrence Dolan; Leora Henkin; Angela D Liese; Scott Isom; Jasmin Divers; Lynne Wagenknecht Journal: Diabetes Care Date: 2021-10-04 Impact factor: 19.112
Authors: Chia-Hsun Chang; Ching-Pyng Kuo; Chien-Ning Huang; Shiow-Li Hwang; Wen-Chun Liao; Meng-Chih Lee Journal: Int J Environ Res Public Health Date: 2021-02-02 Impact factor: 3.390
Authors: Leocadio Rodríguez-Mañas; Javier Angulo; José A Carnicero; Mariam El Assar; Francisco J García-García; Alan J Sinclair Journal: Geroscience Date: 2021-06-01 Impact factor: 7.581
Authors: Ching-Pyng Kuo; Shu-Hua Lu; Chien-Ning Huang; Wen-Chun Liao; Meng-Chih Lee Journal: Int J Environ Res Public Health Date: 2021-03-15 Impact factor: 3.390