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Open Access 01-02-2021 | Diabetes | Article

Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses

Authors: Natalie Nanayakkara, Andrea J. Curtis, Stephane Heritier, Adelle M. Gadowski, Meda E. Pavkov, Timothy Kenealy, David R. Owens, Rebecca L. Thomas, Soon Song, Jencia Wong, Juliana C.-N. Chan, Andrea O.-Y. Luk, Giuseppe Penno, Linong Ji, Viswanathan Mohan, Anandakumar Amutha, Pedro Romero-Aroca, Danijela Gasevic, Dianna J. Magliano, Helena J. Teede, John Chalmers, Sophia Zoungas

Published in: Diabetologia | Issue 2/2021

Abstract

Aims/hypothesis

Few studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise the risk of mortality, macrovascular complications and microvascular complications associated with age at diagnosis of type 2 diabetes.

Methods

Data were sourced from MEDLINE and All EBM (Evidence Based Medicine) databases from inception to July 2018. Observational studies, investigating the effect of age at diabetes diagnosis on macrovascular and microvascular diabetes complications in adults with type 2 diabetes were selected according to pre-specified criteria. Two investigators independently extracted data and evaluated all studies. If data were not reported in a comparable format, data were obtained from authors, presented as minimally adjusted ORs (and 95% CIs) per 1 year increase in age at diabetes diagnosis, adjusted for current age for each outcome of interest. The study protocol was recorded with PROSPERO International Prospective Register of Systematic Reviews (CRD42016043593).

Results

Data from 26 observational studies comprising 1,325,493 individuals from 30 countries were included. Random-effects meta-analyses with inverse variance weighting were used to obtain the pooled ORs. Age at diabetes diagnosis was inversely associated with risk of all-cause mortality and macrovascular and microvascular disease (all p < 0.001). Each 1 year increase in age at diabetes diagnosis was associated with a 4%, 3% and 5% decreased risk of all-cause mortality, macrovascular disease and microvascular disease, respectively, adjusted for current age. The effects were consistent for the individual components of the composite outcomes (all p < 0.001).

Conclusions/interpretation

Younger, rather than older, age at diabetes diagnosis was associated with higher risk of mortality and vascular disease. Early and sustained interventions to delay type 2 diabetes onset and improve blood glucose levels and cardiovascular risk profiles of those already diagnosed are essential to reduce morbidity and mortality.

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Title: Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses
Authors: Natalie Nanayakkara
Andrea J. Curtis
Stephane Heritier
Adelle M. Gadowski
Meda E. Pavkov
Timothy Kenealy
David R. Owens
Rebecca L. Thomas
Soon Song
Jencia Wong
Juliana C.-N. Chan
Andrea O.-Y. Luk
Giuseppe Penno
Linong Ji
Viswanathan Mohan
Anandakumar Amutha
Pedro Romero-Aroca
Danijela Gasevic
Dianna J. Magliano
Helena J. Teede
John Chalmers
Sophia Zoungas
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: Diabetes
Type 2 Diabetes
Published in: Diabetologia / Issue 2/2021
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-020-05319-w

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