title: Age at type 2 diabetes onset and glycaemic control: results from the National Health and Nutrition Examination Survey (NHANES) 2005-2010.
abstract: OBJECTIVE
  We tested the hypothesis that age younger than 65 years at type 2 diabetes diagnosis is associated with worse subsequent glycaemic control.
  
  
  METHODS
  A cross-sectional analysis of data from participants in the 2005-2010 National Health and Nutrition Examination Survey was performed. For adults with self-reported diabetes, we dichotomised age at diabetes diagnosis as younger (<65 years) vs older (≥ 65 years). The primary outcome of interest was HbA1c >9.0% (75 mmol/mol). Secondary outcomes were HbA1c >8.0% (64 mmol/mol) and >7.0% (53 mmol/mol). We used multivariable logistic regression for analysis.
  
  
  RESULTS
  Among 1,438 adults with diabetes, a higher proportion of those <65 years at diagnosis compared with those ≥ 65 at diagnosis had an HbA1c >9.0% (14.4% vs 2.5%, p  <  0.001). After adjustment for sex, race/ethnicity, education, income, insurance, usual source of care, hyperglycaemia medication, duration of diabetes, family history, BMI and waist circumference, age <65 years at diagnosis remained significantly associated with greater odds of HbA1c >9.0% (OR 3.22, 95% CI 1.54, 6.72), HbA1c >8.0% (OR 2.72, 95% CI 1.43, 5.16) and HbA1c >7.0% (OR 1.92, 95% CI 1.18, 3.11). The younger group reported fewer comorbidities, but were less likely to report good health (OR 0.54, 95% CI 0.36, 0.83).
  
  
  CONCLUSIONS
  Younger age at type 2 diabetes diagnosis is significantly associated with worse subsequent glycaemic control. Because patients who are younger at diagnosis have fewer competing comorbidities and complications, safe, aggressive, individualised treatment could benefit this higher-risk group.
authors.affiliation: General Medicine Division, Department of Medicine, Massachusetts General Hospital, 50 Staniford St, 9th Floor, Boston, MA, 02114, USA, SABerkowitz@partners.org.
authors.forename: Seth A
authors.initials: SA
authors.lastname: Berkowitz
authors.forename: James B
authors.initials: JB
authors.lastname: Meigs
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Wexler
mesh_terms: D017668:Age of Onset; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human