Morbidity and mortality in young-onset type 2 diabetes in comparison to type 1 diabetes: where are we now?
Increasingly, we recognise that type 2 diabetes in youth is a disease with an aggressive time course and a significant complication risk. On the other hand, outcomes for youth with type 1 diabetes appear generally to be improving. With increasing numbers of both types of diabetes in youth, it is timely that a comparative perspective is offered to help clinicians prognosticate more appropriately. Contemporary comparative studies add a new perspective to a consistent story, that for youth-onset type 2 diabetes, the development and progression of cardio-renal complications are increased and the survival prognosis is significantly worse than for type 1 diabetes. Here, we review this mounting evidence, highlight the importance of metabolic syndrome factors in the excess risk and underscore that there remains a significant mortality gap for youth with either type of diabetes, to be addressed as a matter of urgency.
Royal Prince Alfred Hospital Diabetes Centre, Level 6 West, Royal Prince Alfred Hospital, Camperdown, Sydney, New South Wales, 2050, Australia, jencia.wong@sswahs.nsw.gov.au.
Jencia
J
Wong
Maria
M
Constantino
Dennis K
DK
Yue
D000293:Adolescent; D017668:Age of Onset; D000419:Albuminuria / Q000209:etiology / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000401:mortality; D002648:Child; D048909:Diabetes Complications / Q000401:mortality*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000401:mortality; D003928:Diabetic Nephropathies / Q000401:mortality; D003929:Diabetic Neuropathies / Q000401:mortality; D018450:Disease Progression; D006801:Humans; D012307:Risk Factors