Department of Diabetes Research, University Hospital of Leicester, Victoria Building Level 1, Leicester Royal Infirmary, Leicester LE1 5WW, United Kingdom.
Prim Care Diabetes. 2011 Apr;5(1):57-62. doi: 10.1016/j.pcd.2010.08.001. Epub 2010 Sep 17.
To describe the clinical characteristics and risk factors of adults <35 years with type 2 diabetes (T2DM).
Observational study of 185 younger adults attending a specialist diabetes clinic.
In this cohort 65% were female, 51% Caucasian, 43% South Asian. Characteristics at presentation: age 24 ± 5.5 years, BMI 33 ± 7.6 kg/m(2) and HbA1c 9.0% ± 2.3. Follow up of 3.2 ± 2.8 years with a diabetes duration of 4.5 ± 3.6 years. HbA1c had improved compared with diagnosis (8.3 ± 2.2% vs. 9.0% ± 2.3%, p<0.0001), but 63% still had an HbA1c>7%. Oral anti-diabetic drugs were used in 72%, insulin alone in 19% and both in 26%. 41% had a BP ≥ 140/80 mmHg, 78% total cholesterol >4 mmol/l, 63% LDL >2 mmol/l, 56% triglycerides >1.7 mmol/l. From diagnosis only the cholesterol and LDL improved significantly, with a modest increase in primary prevention therapy (statin 12-26%, p<0.0001, anti-hypertensives 16-29%, p<0.0001, aspirin 8-12%, p=0.18). 13% had retinopathy, 21% microalbuminuria. 46% had not been reviewed within the past year.
This group represents an extreme phenotype with a high prevalence of insufficiently treated metabolic risk factors. There is need for tailored management strategies to engage and aggressively manage this high-risk group.
描述 35 岁以下成人 2 型糖尿病（T2DM）患者的临床特征和危险因素。
对参加专科糖尿病诊所的 185 名年轻成年人进行观察性研究。
该队列中，65%为女性，51%为白种人，43%为南亚人。就诊时的特征为：年龄 24 ± 5.5 岁，BMI 33 ± 7.6kg/m(2)，HbA1c 9.0% ± 2.3。随访 3.2 ± 2.8 年，糖尿病病程为 4.5 ± 3.6 年。与诊断时相比，HbA1c 有所改善（8.3 ± 2.2%比 9.0% ± 2.3%，p<0.0001），但仍有 63%的患者 HbA1c>7%。72%使用口服降糖药，19%单独使用胰岛素，26%两者均使用。41%的患者血压≥140/80mmHg，78%的患者总胆固醇>4mmol/l，63%的患者 LDL>2mmol/l，56%的患者甘油三酯>1.7mmol/l。从诊断开始，只有胆固醇和 LDL 显著改善，初级预防治疗略有增加（他汀类药物 12-26%，p<0.0001，抗高血压药物 16-29%，p<0.0001，阿司匹林 8-12%，p=0.18）。13%的患者有视网膜病变，21%的患者有微量白蛋白尿。46%的患者在过去一年中未接受复查。
该组代表了一种极端表型，存在大量代谢危险因素治疗不足的情况。需要制定针对性的管理策略，以吸引和积极管理这一高危人群。
