Temporal Trend in Young-Onset Type 2 Diabetes-Macrovascular and Mortality Risk: Study of U.K. Primary Care Electronic Medical Records
To evaluate temporal prevalence trend, cardiometabolic risk factors, and the risk of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality (ACM) in incident young- and usual-onset type 2 diabetes. From the U.K. primary care database, 370,854 people with a new diagnosis of type 2 dia...
Gespeichert in:
| Veröffentlicht in: | Diabetes care 2020-09, Vol.43 (9), p.2208-2216 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 2216 |
|---|---|
| container_issue | 9 |
| container_start_page | 2208 |
| container_title | Diabetes care |
| container_volume | 43 |
| creator | Koye, Digsu N Ling, Joanna Dibato, John Khunti, Kamlesh Montvida, Olga Paul, Sanjoy K |
| description | To evaluate temporal prevalence trend, cardiometabolic risk factors, and the risk of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality (ACM) in incident young- and usual-onset type 2 diabetes.
From the U.K. primary care database, 370,854 people with a new diagnosis of type 2 diabetes from 2000 to 2017 were identified. Analyses were conducted by age-group (18-39, 40-49, 50-59, 60-69, 70-79 years) and high-/low-risk status without history of ASCVD at diagnosis, with subjects with two or more of current smoking, high systolic blood pressure, high LDL cholesterol (LDL-C), or chronic kidney disease classified as high risk.
The proportion of people aged |
| doi_str_mv | 10.2337/dc20-0417 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2420153963</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2420153963</sourcerecordid><originalsourceid>FETCH-LOGICAL-c313t-b937c2dd7535d04bd9b0b817e858464689f9e7d3ab0f6c351b5c4d05b5ee7923</originalsourceid><addsrcrecordid>eNpdkbtO3EAUhkcRKCwkBS8QjURDCi9z90w6tEBAsCIiTkFlzeU4MvF6lhk70j5A3jteLVBQneY7_7l8CB1TMmecl2fBM1IQQcsPaEYNl4WUQu-hGaHCFNIYdoAOc34ihAih9Ud0wJmiShE9Q_8qWK1jsh2uEvQBtz1-jGP_u7jvMwy42qwBM3zRWgcD5GJpfYp_bfZjZxO2U8MypsF27bDBD23-8w3_HMawwbHBv-a3c_wjtSubNnhhE-DLDvyQYt96vITQ-mnoA_iYQv6E9hvbZfj8Uo9QdXVZLa6Lu_vvN4vzu8JzyofCGV56FkIpuQxEuGAccZqWoKUWSihtGgNl4NaRRnkuqZNeBCKdBCgN40fodBe7TvF5hDzUqzZ76DrbQxxzzQQjVHKj-ISevEOf4pj6abmJEkKVQhk9UV931PSVnBM09Xp3cE1JvVVTb9XUWzUT--UlcXQrCG_kqwv-H7HSiCQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2444674698</pqid></control><display><type>article</type><title>Temporal Trend in Young-Onset Type 2 Diabetes-Macrovascular and Mortality Risk: Study of U.K. Primary Care Electronic Medical Records</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Koye, Digsu N ; Ling, Joanna ; Dibato, John ; Khunti, Kamlesh ; Montvida, Olga ; Paul, Sanjoy K</creator><creatorcontrib>Koye, Digsu N ; Ling, Joanna ; Dibato, John ; Khunti, Kamlesh ; Montvida, Olga ; Paul, Sanjoy K</creatorcontrib><description>To evaluate temporal prevalence trend, cardiometabolic risk factors, and the risk of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality (ACM) in incident young- and usual-onset type 2 diabetes.
From the U.K. primary care database, 370,854 people with a new diagnosis of type 2 diabetes from 2000 to 2017 were identified. Analyses were conducted by age-group (18-39, 40-49, 50-59, 60-69, 70-79 years) and high-/low-risk status without history of ASCVD at diagnosis, with subjects with two or more of current smoking, high systolic blood pressure, high LDL cholesterol (LDL-C), or chronic kidney disease classified as high risk.
The proportion of people aged <50 years at diagnosis increased during 2000-2010 and then stabilized. The incidence rates of ASCVD and ACM declined in people aged ≥50 years but did not decrease in people <50 years. Compared with people aged ≥50 years, those aged 18-39 years at diagnosis had a higher proportion of obesity (71% obese) and higher HbA
(8.6%), and 71% had high LDL-C, while only 18% were on cardioprotective therapy. Although 2% in this age-group had ASCVD at diagnosis, 23% were identified as high risk. In the 18-39-year age-group, the adjusted average years to ASCVD/ACM in high-risk individuals (9.1 years [95% CI 8.2-10.0]/9.3 years [8.1-10.4]) were similar to the years in those with low risk (10.0 years [9.5-10.5]/10.5 years [9.7-11.2]). However, individuals aged ≥50 years with high risk were likely to experience an ASCVD event 1.5-2 years earlier and death 1.1-1.5 years earlier compared with low-risk groups (
< 0.01).
Unlike usual-onset, young-onset type 2 diabetes has similar cardiovascular and mortality risk irrespective of cardiometabolic risk factor status at diagnosis. The guidelines on the management of young-onset type 2 diabetes for intensive risk factor management and cardioprotective therapies need to be urgently reevaluated through prospective studies.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc20-0417</identifier><identifier>PMID: 32616608</identifier><language>eng</language><publisher>United States: American Diabetes Association</publisher><subject>Adolescent ; Adult ; Age ; Age of Onset ; Aged ; Arteriosclerosis ; Atherosclerosis ; Blood pressure ; Cardiovascular diseases ; Cholesterol ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetic Angiopathies - epidemiology ; Diabetic Angiopathies - mortality ; Diagnosis ; Electronic health records ; Electronic Health Records - statistics & numerical data ; Electronic Health Records - trends ; Electronic medical records ; Female ; Health risks ; Heart Disease Risk Factors ; Humans ; Incidence ; Kidney diseases ; Low density lipoprotein ; Male ; Middle Aged ; Mortality ; Mortality - trends ; Obesity ; Primary care ; Primary Health Care - statistics & numerical data ; Primary Health Care - trends ; Prospective Studies ; Research design ; Risk analysis ; Risk Factors ; Risk groups ; Risk management ; United Kingdom - epidemiology ; Young Adult</subject><ispartof>Diabetes care, 2020-09, Vol.43 (9), p.2208-2216</ispartof><rights>2020 by the American Diabetes Association.</rights><rights>Copyright American Diabetes Association Sep 1, 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c313t-b937c2dd7535d04bd9b0b817e858464689f9e7d3ab0f6c351b5c4d05b5ee7923</citedby><cites>FETCH-LOGICAL-c313t-b937c2dd7535d04bd9b0b817e858464689f9e7d3ab0f6c351b5c4d05b5ee7923</cites><orcidid>0000-0003-0848-7194 ; 0000-0003-2343-7099</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32616608$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koye, Digsu N</creatorcontrib><creatorcontrib>Ling, Joanna</creatorcontrib><creatorcontrib>Dibato, John</creatorcontrib><creatorcontrib>Khunti, Kamlesh</creatorcontrib><creatorcontrib>Montvida, Olga</creatorcontrib><creatorcontrib>Paul, Sanjoy K</creatorcontrib><title>Temporal Trend in Young-Onset Type 2 Diabetes-Macrovascular and Mortality Risk: Study of U.K. Primary Care Electronic Medical Records</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>To evaluate temporal prevalence trend, cardiometabolic risk factors, and the risk of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality (ACM) in incident young- and usual-onset type 2 diabetes.
From the U.K. primary care database, 370,854 people with a new diagnosis of type 2 diabetes from 2000 to 2017 were identified. Analyses were conducted by age-group (18-39, 40-49, 50-59, 60-69, 70-79 years) and high-/low-risk status without history of ASCVD at diagnosis, with subjects with two or more of current smoking, high systolic blood pressure, high LDL cholesterol (LDL-C), or chronic kidney disease classified as high risk.
The proportion of people aged <50 years at diagnosis increased during 2000-2010 and then stabilized. The incidence rates of ASCVD and ACM declined in people aged ≥50 years but did not decrease in people <50 years. Compared with people aged ≥50 years, those aged 18-39 years at diagnosis had a higher proportion of obesity (71% obese) and higher HbA
(8.6%), and 71% had high LDL-C, while only 18% were on cardioprotective therapy. Although 2% in this age-group had ASCVD at diagnosis, 23% were identified as high risk. In the 18-39-year age-group, the adjusted average years to ASCVD/ACM in high-risk individuals (9.1 years [95% CI 8.2-10.0]/9.3 years [8.1-10.4]) were similar to the years in those with low risk (10.0 years [9.5-10.5]/10.5 years [9.7-11.2]). However, individuals aged ≥50 years with high risk were likely to experience an ASCVD event 1.5-2 years earlier and death 1.1-1.5 years earlier compared with low-risk groups (
< 0.01).
Unlike usual-onset, young-onset type 2 diabetes has similar cardiovascular and mortality risk irrespective of cardiometabolic risk factor status at diagnosis. The guidelines on the management of young-onset type 2 diabetes for intensive risk factor management and cardioprotective therapies need to be urgently reevaluated through prospective studies.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Age of Onset</subject><subject>Aged</subject><subject>Arteriosclerosis</subject><subject>Atherosclerosis</subject><subject>Blood pressure</subject><subject>Cardiovascular diseases</subject><subject>Cholesterol</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetic Angiopathies - epidemiology</subject><subject>Diabetic Angiopathies - mortality</subject><subject>Diagnosis</subject><subject>Electronic health records</subject><subject>Electronic Health Records - statistics & numerical data</subject><subject>Electronic Health Records - trends</subject><subject>Electronic medical records</subject><subject>Female</subject><subject>Health risks</subject><subject>Heart Disease Risk Factors</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kidney diseases</subject><subject>Low density lipoprotein</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Mortality - trends</subject><subject>Obesity</subject><subject>Primary care</subject><subject>Primary Health Care - statistics & numerical data</subject><subject>Primary Health Care - trends</subject><subject>Prospective Studies</subject><subject>Research design</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Risk groups</subject><subject>Risk management</subject><subject>United Kingdom - epidemiology</subject><subject>Young Adult</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkbtO3EAUhkcRKCwkBS8QjURDCi9z90w6tEBAsCIiTkFlzeU4MvF6lhk70j5A3jteLVBQneY7_7l8CB1TMmecl2fBM1IQQcsPaEYNl4WUQu-hGaHCFNIYdoAOc34ihAih9Ud0wJmiShE9Q_8qWK1jsh2uEvQBtz1-jGP_u7jvMwy42qwBM3zRWgcD5GJpfYp_bfZjZxO2U8MypsF27bDBD23-8w3_HMawwbHBv-a3c_wjtSubNnhhE-DLDvyQYt96vITQ-mnoA_iYQv6E9hvbZfj8Uo9QdXVZLa6Lu_vvN4vzu8JzyofCGV56FkIpuQxEuGAccZqWoKUWSihtGgNl4NaRRnkuqZNeBCKdBCgN40fodBe7TvF5hDzUqzZ76DrbQxxzzQQjVHKj-ISevEOf4pj6abmJEkKVQhk9UV931PSVnBM09Xp3cE1JvVVTb9XUWzUT--UlcXQrCG_kqwv-H7HSiCQ</recordid><startdate>202009</startdate><enddate>202009</enddate><creator>Koye, Digsu N</creator><creator>Ling, Joanna</creator><creator>Dibato, John</creator><creator>Khunti, Kamlesh</creator><creator>Montvida, Olga</creator><creator>Paul, Sanjoy K</creator><general>American Diabetes Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0848-7194</orcidid><orcidid>https://orcid.org/0000-0003-2343-7099</orcidid></search><sort><creationdate>202009</creationdate><title>Temporal Trend in Young-Onset Type 2 Diabetes-Macrovascular and Mortality Risk: Study of U.K. Primary Care Electronic Medical Records</title><author>Koye, Digsu N ; Ling, Joanna ; Dibato, John ; Khunti, Kamlesh ; Montvida, Olga ; Paul, Sanjoy K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c313t-b937c2dd7535d04bd9b0b817e858464689f9e7d3ab0f6c351b5c4d05b5ee7923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Age of Onset</topic><topic>Aged</topic><topic>Arteriosclerosis</topic><topic>Atherosclerosis</topic><topic>Blood pressure</topic><topic>Cardiovascular diseases</topic><topic>Cholesterol</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetic Angiopathies - epidemiology</topic><topic>Diabetic Angiopathies - mortality</topic><topic>Diagnosis</topic><topic>Electronic health records</topic><topic>Electronic Health Records - statistics & numerical data</topic><topic>Electronic Health Records - trends</topic><topic>Electronic medical records</topic><topic>Female</topic><topic>Health risks</topic><topic>Heart Disease Risk Factors</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kidney diseases</topic><topic>Low density lipoprotein</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Mortality - trends</topic><topic>Obesity</topic><topic>Primary care</topic><topic>Primary Health Care - statistics & numerical data</topic><topic>Primary Health Care - trends</topic><topic>Prospective Studies</topic><topic>Research design</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Risk groups</topic><topic>Risk management</topic><topic>United Kingdom - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koye, Digsu N</creatorcontrib><creatorcontrib>Ling, Joanna</creatorcontrib><creatorcontrib>Dibato, John</creatorcontrib><creatorcontrib>Khunti, Kamlesh</creatorcontrib><creatorcontrib>Montvida, Olga</creatorcontrib><creatorcontrib>Paul, Sanjoy K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koye, Digsu N</au><au>Ling, Joanna</au><au>Dibato, John</au><au>Khunti, Kamlesh</au><au>Montvida, Olga</au><au>Paul, Sanjoy K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Temporal Trend in Young-Onset Type 2 Diabetes-Macrovascular and Mortality Risk: Study of U.K. Primary Care Electronic Medical Records</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2020-09</date><risdate>2020</risdate><volume>43</volume><issue>9</issue><spage>2208</spage><epage>2216</epage><pages>2208-2216</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><abstract>To evaluate temporal prevalence trend, cardiometabolic risk factors, and the risk of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality (ACM) in incident young- and usual-onset type 2 diabetes.
From the U.K. primary care database, 370,854 people with a new diagnosis of type 2 diabetes from 2000 to 2017 were identified. Analyses were conducted by age-group (18-39, 40-49, 50-59, 60-69, 70-79 years) and high-/low-risk status without history of ASCVD at diagnosis, with subjects with two or more of current smoking, high systolic blood pressure, high LDL cholesterol (LDL-C), or chronic kidney disease classified as high risk.
The proportion of people aged <50 years at diagnosis increased during 2000-2010 and then stabilized. The incidence rates of ASCVD and ACM declined in people aged ≥50 years but did not decrease in people <50 years. Compared with people aged ≥50 years, those aged 18-39 years at diagnosis had a higher proportion of obesity (71% obese) and higher HbA
(8.6%), and 71% had high LDL-C, while only 18% were on cardioprotective therapy. Although 2% in this age-group had ASCVD at diagnosis, 23% were identified as high risk. In the 18-39-year age-group, the adjusted average years to ASCVD/ACM in high-risk individuals (9.1 years [95% CI 8.2-10.0]/9.3 years [8.1-10.4]) were similar to the years in those with low risk (10.0 years [9.5-10.5]/10.5 years [9.7-11.2]). However, individuals aged ≥50 years with high risk were likely to experience an ASCVD event 1.5-2 years earlier and death 1.1-1.5 years earlier compared with low-risk groups (
< 0.01).
Unlike usual-onset, young-onset type 2 diabetes has similar cardiovascular and mortality risk irrespective of cardiometabolic risk factor status at diagnosis. The guidelines on the management of young-onset type 2 diabetes for intensive risk factor management and cardioprotective therapies need to be urgently reevaluated through prospective studies.</abstract><cop>United States</cop><pub>American Diabetes Association</pub><pmid>32616608</pmid><doi>10.2337/dc20-0417</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-0848-7194</orcidid><orcidid>https://orcid.org/0000-0003-2343-7099</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0149-5992 |
| ispartof | Diabetes care, 2020-09, Vol.43 (9), p.2208-2216 |
| issn | 0149-5992 1935-5548 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2420153963 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adolescent Adult Age Age of Onset Aged Arteriosclerosis Atherosclerosis Blood pressure Cardiovascular diseases Cholesterol Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - epidemiology Diabetic Angiopathies - epidemiology Diabetic Angiopathies - mortality Diagnosis Electronic health records Electronic Health Records - statistics & numerical data Electronic Health Records - trends Electronic medical records Female Health risks Heart Disease Risk Factors Humans Incidence Kidney diseases Low density lipoprotein Male Middle Aged Mortality Mortality - trends Obesity Primary care Primary Health Care - statistics & numerical data Primary Health Care - trends Prospective Studies Research design Risk analysis Risk Factors Risk groups Risk management United Kingdom - epidemiology Young Adult |
| title | Temporal Trend in Young-Onset Type 2 Diabetes-Macrovascular and Mortality Risk: Study of U.K. Primary Care Electronic Medical Records |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T13%3A52%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Temporal%20Trend%20in%20Young-Onset%20Type%202%20Diabetes-Macrovascular%20and%20Mortality%20Risk:%20Study%20of%20U.K.%20Primary%20Care%20Electronic%20Medical%20Records&rft.jtitle=Diabetes%20care&rft.au=Koye,%20Digsu%20N&rft.date=2020-09&rft.volume=43&rft.issue=9&rft.spage=2208&rft.epage=2216&rft.pages=2208-2216&rft.issn=0149-5992&rft.eissn=1935-5548&rft_id=info:doi/10.2337/dc20-0417&rft_dat=%3Cproquest_cross%3E2420153963%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2444674698&rft_id=info:pmid/32616608&rfr_iscdi=true |