title: Characteristics, complications and management of a large multiethnic cohort of younger adults with type 2 diabetes.
abstract: OBJECTIVE
  To describe the characteristics and management of a cohort with type 2 diabetes (T2DM) <40 years.
  
  
  METHODS
  Cross-sectional study of the last visit of 648 adults attending 2 specialist centres in the UK. Differences between the lowest (≤22) vs. highest quintile (≥33) of age of diagnosis were analysed.
  
  
  RESULTS
  57.9% were female; 45.5% Black or Minority Ethnic origin (91.9% of South Asian origin); median age at diagnosis was 28 years (24-31); diabetes duration of 4.0 years (1.9-7.0); BMI of 33.0 kg/m(2) (28.3-38.7). HbA1c of 8.2% (6.8-9.9) with HbA1c >7% in 70%. 71.8% had cholesterol >4 mmol/l, 54.9% triglycerides >1.7 mmol/l, 45% had hypertension, 19.8% retinopathy, 16.9% microalbuminuria. Insulin was used in 43.3%. 27.7% received antihypertensives and 31.5% a statin. Compared to the highest quintile of age of diagnosis, the lowest quintile had more often retinopathy (22.1% vs. 16.9%, p=0.021), was less on insulin (45.6% vs. 46.4%, p=0.039) and often managed with diet only (9.6% vs. 6.2%, p=0.005).
  
  
  CONCLUSIONS
  These younger adults with T2DM often have inadequately treated risk factors. In particular, patients from the lowest quintile of age of diagnosis were less aggressively treated. There is a need for tailored strategies to manage this high-risk group.
authors.affiliation: Diabetes Research, University Hospital of Leicester, Victoria Building Level 1, Leicester Royal Infirmary, Leicester LE1 5WW, UK. kbenhalima@hotmail.com
authors.forename: Katrien
authors.initials: K
authors.lastname: Benhalima
authors.forename: Soon H
authors.initials: SH
authors.lastname: Song
authors.forename: Emma G
authors.initials: EG
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; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology; D050171:Dyslipidemias / Q000188:drug therapy / Q000208:ethnology; D004739:England / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy / Q000208:ethnology; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D009765:Obesity / Q000208:ethnology; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; D008055:Lipids; C517652:hemoglobin A1c protein, human