title: Type 2 diabetes in younger adults: clinical characteristics, diabetes-related complications and management of risk factors.
abstract: OBJECTIVE
  To describe the clinical characteristics and risk factors of adults <35 years with type 2 diabetes (T2DM).
  
  
  METHODS
  Observational study of 185 younger adults attending a specialist diabetes clinic.
  
  
  RESULTS
  In this cohort 65% were female, 51% Caucasian, 43% South Asian. Characteristics at presentation: age 24 ± 5.5 years, BMI 33 ± 7.6 kg/m(2) and HbA1c 9.0% ± 2.3. Follow up of 3.2 ± 2.8 years with a diabetes duration of 4.5 ± 3.6 years. HbA1c had improved compared with diagnosis (8.3 ± 2.2% vs. 9.0% ± 2.3%, p<0.0001), but 63% still had an HbA1c>7%. Oral anti-diabetic drugs were used in 72%, insulin alone in 19% and both in 26%. 41% had a BP ≥ 140/80 mmHg, 78% total cholesterol >4 mmol/l, 63% LDL >2 mmol/l, 56% triglycerides >1.7 mmol/l. From diagnosis only the cholesterol and LDL improved significantly, with a modest increase in primary prevention therapy (statin 12-26%, p<0.0001, anti-hypertensives 16-29%, p<0.0001, aspirin 8-12%, p=0.18). 13% had retinopathy, 21% microalbuminuria. 46% had not been reviewed within the past year.
  
  
  CONCLUSIONS
  This group represents an extreme phenotype with a high prevalence of insufficiently treated metabolic risk factors. There is need for tailored management strategies to engage and aggressively manage this high-risk group.
authors.affiliation: Department of Diabetes Research, University Hospital of Leicester, Victoria Building Level 1, Leicester Royal Infirmary, Leicester LE1 5WW, United Kingdom. kbenhalima@hotmail.com
authors.forename: Katrien
authors.initials: K
authors.lastname: Benhalima
authors.forename: Emma
authors.initials: E
authors.lastname: Wilmot
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Gray
authors.forename: Ian
authors.initials: I
authors.lastname: Lawrence
authors.forename: Melanie
authors.initials: M
authors.lastname: Davies
mesh_terms: D000328:Adult; D017668:Age of Onset; D044466:Asian People / Q000706:statistics & numerical data; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D048909:Diabetes Complications / Q000188:drug therapy* / Q000208:ethnology / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology; D004739:England / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D010044:Outpatient Clinics, Hospital; D010641:Phenotype; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human