Association of Type 1 Diabetes vs Type 2 Diabetes Diagnosed During Childhood and Adolescence With Complications During Teenage Years and Young Adulthood

作者：Dabelea, Dana^*; Stafford, Jeanette M.; Mayer-Davis, Elizabeth J.; D'Agostino, Ralph; Dolan, Lawrence; Imperatore, Giuseppina; Linder, Barbara; Lawrence, Jean M.; Marcovina, Santica M.; Mottl, Amy K.; Black, Mary Helen; Pop-Busui, Rodica; Saydah, Sharon; Hamman, Richard F.; Pihoker, Catherine

来源：JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2017, 317(8): 825-835.

DOI：10.1001/jama.2017.0686

• PERIPHERAL NEUROPATHY
• ONSET TYPE-1
• RISK-FACTORS
• YOUTH
• SEARCH
• PREVALENCE
• MORTALITY
• COHORT
• TRIAL/EPIDEMIOLOGY
• INTERVENTIONS

IMPORTANCE The burden and determinants of complications and comorbidities in contemporary youth-onset diabetes are unknown. @@@ OBJECTIVE 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. @@@ DESIGN, SETTING, AND PARTICIPANTS 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. @@@ EXPOSURES Type 1 and type 2 diabetes and established risk factors (hemoglobin A(1c) level, body mass index, waist-height ratio, and mean arterial blood pressure). @@@ MAIN OUTCOMES AND MEASURES Diabetic kidney disease, retinopathy, peripheral neuropathy, cardiovascular autonomic neuropathy, arterial stiffness, and hypertension. @@@ RESULTS 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 all measured complications except cardiovascular autonomic neuropathy. 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, retinopathy, and peripheral neuropathy but no significant difference in the odds of arterial stiffness and hypertension. @@@ [GRAPHICS] @@@ CONCLUSIONS AND RELEVANCE 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.

• 出版日期2017-2-28