Younger-onset compared with later-onset type 2 diabetes: an analysis of the UK Prospective Diabetes Study (UKPDS) with up to 30 years of follow-up (UKPDS 92)
Authors' conclusion
The risk of dying relative to the general population is even greater for people diagnosed with type 2 diabetes at younger ages. The increased risk of complications and poorer glycaemic control in younger-onset type 2 diabetes calls for the development of services to identify and manage these individuals.
Study context
- Population
- UKPDS participants aged 25–65 years with newly diagnosed T2D, without diabetes autoantibodies, 1977–2007; 59.4% male, mean HbA1c 76 mmol/molautoantibody-negative
- Participants
- 4,550 participants
- Comparison
- Younger-onset vs later-onset T2D
- Younger-onsetn = 429
- Primary endpoint
- SMR vs UK general population and incidence rates of prespecified outcomes
- Follow-up
- Median 17.5 years (IQR 12.7-20.8)
Methodological detailsup to 30 years of follow-up
- Up to 30 years of follow-up
Primary result
As reported in the abstract
SMR
Younger-onset
3.72
Standardised mortality ratios (SMR) · 95% CI 2.98–4.64
Later-onset
1.54
SMR · CI 1.47–1.61
Further findings
Microvascular disease incidence
Microvascular disease incidence
- Incidence rate higher for all other outcomes in later-onset T2D
5-year incidence at any given age
- 5-year incidence of any diabetes-related endpoint, all-cause mortality, microvascular disease and MI higher with younger age at diagnosis
Annual mean HbA1c · first 20 years
- Higher in younger-onset vs later-onset T2D
Intensive vs conventional glycaemic control by onset subgroup
- No interactions by younger- vs later-onset subgroup for any outcome
Original publication
Younger-onset compared with later-onset type 2 diabetes: an analysis of the UK Prospective Diabetes Study (UKPDS) with up to 30 years of follow-up (UKPDS 92). Lancet Diabetes Endocrinol. Published 23 October 2024. doi:10.
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