The earlier diabetes develops, the more dangerous it is! Two studies from China and the UK

The earlier you develop a chronic disease, the greater the trouble you will have in the future, such as type 2 diabetes.

On April 22, Diabetes Care published a new analysis based on data from 100,000 people in the Kailuan Study, suggesting that the earlier one develops type 2 diabetes, the higher the risk of cardiovascular disease and all-cause mortality.

The researchers found that during a median follow-up of 5.57 years, people who developed type 2 diabetes before the age of 45 had the highest risk of cardiovascular disease, stroke, and death compared with people without diabetes, with risks increased by 2.21 times, 1.99 times, and 3.79 times, respectively.

As the age of onset of type 2 diabetes increases, the risk of cardiovascular disease and all-cause mortality gradually decreases.

The researchers included 101,080 people without diabetes and cardiovascular disease at baseline from the Kailuan study, all of whom were monitored every two years until the end of 2017. During the observation period, a total of 11,384 people were diagnosed with type 2 diabetes, and people matched with their age and sex were randomly selected as controls, and finally 10,777 pairs of case-control subjects were included.

During a median follow-up of 5.57 years, 907 cardiovascular events occurred (725 strokes) and 887 deaths occurred.

In fact, the younger people are when they develop type 2 diabetes, the higher their risk of developing vascular complications in the future and the more likely they are to develop dementia.

A British study published in the journal JAMA on April 27 showed that by the age of 70, the risk of dementia increases by 24% for every 5 years earlier the onset of type 2 diabetes.

During a median follow-up of 31.7 years, the incidence of dementia in people without diabetes was 8.9 per 1,000 person-years at the age of 70, while the incidence of dementia in people who developed type 2 diabetes aged 65-70, 60-64, and before 60 was 10 per 1,000 person-years, 13 per 1,000 person-years, and 18.3 per 1,000 person-years, respectively.

Multivariate analysis showed that compared with people without diabetes at the age of 70, the risk of dementia in people aged 65-70, 60-64, and before 60 increased by 11%, 49%, and 112%, respectively.

Further analysis showed a hierarchical association between the age of onset of type 2 diabetes and the risk of dementia.

The study included 10,095 subjects with a baseline age of 35 to 55 years from the UK Whitehall II prospective cohort study. During a median follow-up of 31.7 years, 1,710 people developed diabetes and 639 were diagnosed with dementia.

Type 2 diabetes was defined as: fasting blood glucose level ≥126 mg/dl, or clinical diagnosis of type 2 diabetes, or use of hypoglycemic drugs, or a record of hospitalization for diabetes.

Previously, Yin Chunlin, Xia Jinggang and others from the Xuanwu Hospital of Capital Medical University published an article in this journal stating that in the pathogenesis of diabetes-induced atherosclerotic complications, oxidative stress and insulin resistance-related metabolic disorders are two important aspects. The interaction between the two leads to more inflammatory responses, and coronary heart disease is a chronic inflammatory disease with abnormal cholesterol metabolism as the "soil".

In terms of treatment, in addition to controlling blood sugar, it is also important to improve metabolic indicators by reducing waist circumference, body mass index and lipid regulation. This can play an additional cardiovascular protective role by reducing oxidative stress, inflammatory response and improving endothelial function.

Source: China Circulation Magazine