title: Association of Type 1 Diabetes vs Type 2 Diabetes Diagnosed During Childhood and Adolescence With Complications During Teenage Years and Young Adulthood.
abstract: The burden and determinants of complications and comorbidities in contemporary youth-onset diabetes are unknown.
  
  
  
  To determine the prevalence of and risk factors for complications related to type 1 diabetes vs type 2 diabetes among teenagers and young adults who had been diagnosed with diabetes during childhood and adolescence.
  
  
  
  Observational study from 2002 to 2015 in 5 US locations, including 2018 participants with type 1 and type 2 diabetes diagnosed at younger than 20 years, with single outcome measures between 2011 and 2015.
  
  
  
  Type 1 and type 2 diabetes and established risk factors (hemoglobin A1c level, body mass index, waist-height ratio, and mean arterial blood pressure).
  
  
  
  Diabetic kidney disease, retinopathy, peripheral neuropathy, cardiovascular autonomic neuropathy, arterial stiffness, and hypertension.
  
  
  
  Of 2018 participants, 1746 had type 1 diabetes (mean age, 17.9 years [SD, 4.1]; 1327 non-Hispanic white [76.0%]; 867 female patients [49.7%]), and 272 had type 2 (mean age, 22.1 years [SD, 3.5]; 72 non-Hispanic white [26.5%]; 181 female patients [66.5%]). Mean diabetes duration was 7.9 years (both groups). Patients with type 2 diabetes vs those with type 1 had higher age-adjusted prevalence of diabetic kidney disease (19.9% vs 5.8%; absolute difference [AD], 14.0%; 95% CI, 9.1%-19.9%; P < .001), retinopathy (9.1% vs 5.6%; AD, 3.5%; 95% CI, 0.4%-7.7%; P = .02), peripheral neuropathy (17.7% vs 8.5%; AD, 9.2%; 95% CI, 4.8%-14.4%; P < .001), arterial stiffness (47.4% vs 11.6%; AD, 35.9%; 95% CI, 29%-42.9%; P < .001), and hypertension (21.6% vs 10.1%; AD, 11.5%; 95% CI, 6.8%-16.9%; P < .001), but not cardiovascular autonomic neuropathy (15.7% vs 14.4%; AD, 1.2%; 95% CI, -3.1% to 6.5; P = .62). After adjustment for established risk factors measured over time, participants with type 2 diabetes vs those with type 1 had significantly higher odds of diabetic kidney disease (odds ratio [OR], 2.58; 95% CI, 1.39-4.81; P=.003), retinopathy (OR, 2.24; 95% CI, 1.11-4.50; P = .02), and peripheral neuropathy (OR, 2.52; 95% CI, 1.43-4.43; P = .001), but no significant difference in the odds of arterial stiffness (OR, 1.07; 95% CI, 0.63-1.84; P = .80) and hypertension (OR, 0.85; 95% CI, 0.50-1.45; P = .55).
  
  
  
  Among teenagers and young adults who had been diagnosed with diabetes during childhood or adolescence, the prevalence of complications and comorbidities was higher among those with type 2 diabetes compared with type 1, but frequent in both groups. These findings support early monitoring of youth with diabetes for development of complications.
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, Aurora.
authors.forename: Dana
authors.initials: D
authors.lastname: Dabelea
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Stafford
authors.affiliation: Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Mayer-Davis
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Ralph
authors.initials: R
authors.lastname: D'Agostino
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Dolan
authors.affiliation: Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Imperatore
authors.affiliation: Division of Diabetes, Endocrinology and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Linder
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.
authors.forename: Jean M
authors.initials: JM
authors.lastname: Lawrence
authors.affiliation: Northwest Lipid Research Laboratory, University of Washington, Seattle.
authors.forename: Santica M
authors.initials: SM
authors.lastname: Marcovina
authors.affiliation: UNC Division of Nephrology and Hypertension, University of North Carolina School of Medicine, Chapel Hill.
authors.forename: Amy K
authors.initials: AK
authors.lastname: Mottl
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.
authors.forename: Mary Helen
authors.initials: MH
authors.lastname: Black
authors.affiliation: Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor.
authors.forename: Rodica
authors.initials: R
authors.lastname: Pop-Busui
authors.affiliation: Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Saydah
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, Aurora.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Hamman
authors.affiliation: Department of Pediatrics, University of Washington, Seattle.
authors.forename: Catherine
authors.initials: C
authors.lastname: Pihoker
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D048909:Diabetes Complications / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D006973:Hypertension; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin