Association of age at diagnosis of type 2 diabetes mellitus with the risks of the morbidity of cardiovascular disease, cancer and all-cause mortality: Evidence from a real-world study with a large population-based cohort study

Abstract

Aims

To investigate the impact of diagnosis age of type 2 diabetes mellitus (T2DM) on subsequent adverse outcomes within the Chinese population.

Methods

549,959 eligible T2DM patients were included from Ningbo and Jinhua city in Zhejiang province, China. Standardized ratio was used to evaluate the risks of coronary heart disease (CHD), stroke, cancer and all-cause death in different T2DM diagnosis age groups.

Results

For all adverse outcomes, higher excess risks were observed in the youngest age group (30–39) than in the oldest age group (≥80) with T2DM. The standardized incidence ratios (SIR) were 5.93 (95% CI: 3.46, 10.14) for CHD, 5.45 (95% CI: 3.72, 7.99) for stroke and 1.85 (95% CI: 1.38, 2.49) for cancer in the youngest age group, and were 1.32 (95% CI: 1.08, 1.60) for CHD, 1.25 (95% CI: 1.08, 1.44) for stroke, and 0.78 (95% CI: 0.56, 1.09) for cancer, respectively, in the oldest age group. The standardized mortality ratios (SMR) for all-cause death were 3.15 (1.69, 5.84) vs. 1.12 (0.88, 1.43). These excess risks decreased with increasing diagnosis age (all P value < 0.001). Consistent results were observed when individuals were stratified by sex or further excluded with the time from T2DM diagnosis to endpoints less than 1 or 2 years.

Conclusions

Th earlier the diagnosis of T2DM, the higher the risk for subsequent adverse outcomes. It is imperative to enhance the management and monitoring of early-onset patients during follow-up.