Complications Vary Greatly Among Youth with Diabetes

Patients with type 2 diabetes more likely to experience signs of kidney, nerve, and eye diseases.

A new study discovered that younger patients with type 2 diabetes were more likely to experience adverse health events related to the disease, compared with patients with type 1 diabetes.

Investigators from the SEARCH for Diabetes in Youth study, which was published by the Journal of the American Medical Association, discovered that patients with type 2 diabetes are more likely to develop signs of kidney, nerve, and eye diseases, and have a grearer risk of heart disease shortly after diagnosis than peers with type 1 diabetes.

The researchers assessed the speed and frequency in which teenagers and young adult patients developed symptoms of kidney, nerve, and eye diseases, which are common among patients with diabetes. Heart disease risk factors were also measured.

Included in the study were 1736 patients with type 1 diabetes and 272 patients with type 2 diabetes, who were all diagnosed before age 20. Investigators also examined blood glucose control, body mass index, waist-to-height ratio, and blood pressure.

By the end of the study, nearly 20% of patients with type 2 diabetes developed symptoms of kidney disease, compared with 6% of patients with type 1 diabetes, according to the study. Patients with type 2 diabetes were 18% more likely to develop nerve disease, and 9% more likely to develop eye disease, compared with only 9% and 6%, respectively, of patients with type 1 diabetes.

Hypertension and arterial stiffness were greater among patients with type 2 diabetes, while cardiovascular autonomic neuropathy was similar among both patient cohorts.

Although patients with type 2 diabetes displayed early signs of diabetes complications, patients in both groups progressed to develop the conditions, according to the study.

“There’s often the assumption that young people don’t develop complications from diabetes, but that’s just not true. We saw that young people with diabetes are developing signs of major complications in the prime of their lives,” said study author Barbara Linder, MD, senior advisor for childhood diabetes research within the National Institute of Diabetes and Digestive and Kidney Diseases. “Particularly for youth with type 2, this research demonstrates the clear need to learn how to reduce or delay the debilitating complications of diabetes, itself a huge challenge for young people to manage.”

Interestingly, the study authors noted that even when other factors were taken into account, the mechanisms underlying why more patients with type 2 diabetes developed complications than patients with type 1 diabetes was unclear.

By age 21, the investigators found that one-third of patients with type 1 diabetes, and three-fourths of patients with type 2 diabetes, experienced at least 1 complication or were at high risk of experiencing a complication, according to the study.

These findings underscore the need for better disease management approaches for younger patients with diabetes to prevent life-long complications, the authors concluded.

“This study highlights the need for early monitoring for development of complications among young people with diabetes,” said study author Sharon Saydah, PhD, senior scientist at CDC. “If young people can delay onset of these complications from diabetes by even a few years, that can ease their burden and lengthen their lives.”