National Diabetes Audit Programme, NHS England & Improvement, London, UK.
Division of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Diabet Med. 2023 Jan;40(1):e14940. doi: 10.1111/dme.14940. Epub 2022 Sep 18.
We report contemporary age-related prevalence, characteristics and care of children and young people with type 2 diabetes in England.
Individuals with a recorded diagnosis of type 2 diabetes between January 2019 and March 2020 were identified from a whole population register. Age, sex, ethnicity, deprivation quintile, weight, HbA and receipt of the nine National Institute for Health & Care Excellence (NICE) recommended annual care processes were extracted from electronic clinical records and analysed by pre-specified age bands.
In total, 122,780 (4.6%) of 2,642,435 individuals in England with type 2 diabetes were aged under 40 years, comprising; 650 (0.5%) under 16 years, 910 (0.7%) aged 16-18 years, 8245 (6.7%) aged 19-25 and 112,975 (92%) aged 26-39 years. Compared to people with type 2 diabetes aged above 40 years, young people were significantly more likely to be from minority ethnic groups: 51% under 16 years, 41% 16-18 years, 38% 19-25 years, 38% 26-39 years, 27% 40-59 years and 15% 60-79 years were of Black or Asian ethnicity. In addition, those aged under 40 years were more likely to be obese, women, to live in the most-deprived socioeconomic areas and less likely to receive the NICE recommended annual care processes or achieve target HbA .
The substantial number of people under 40 years of age with type 2 diabetes, are more likely to have characteristics associated with inequalities and are less likely to achieve HbA targets and receive recommended care processes. These findings highlight the need to consider novel approaches to service provision for this high-risk group.
我们报告了英国当代年龄相关的 2 型糖尿病儿童和青少年的患病率、特征和治疗情况。
从全人群登记处确定了 2019 年 1 月至 2020 年 3 月期间记录的 2 型糖尿病患者。从电子临床记录中提取年龄、性别、种族、贫困五分位数、体重、HbA 和接受国家卫生与保健卓越研究所（NICE）推荐的 9 项年度护理流程等信息，并按预先指定的年龄组进行分析。
在英格兰，共有 122780 名（4.6%）2642435 名 2 型糖尿病患者年龄在 40 岁以下，其中 650 名（0.5%）年龄在 16 岁以下，910 名（0.7%）年龄在 16-18 岁，8245 名（6.7%）年龄在 19-25 岁，112975 名（92%）年龄在 26-39 岁。与年龄在 40 岁以上的 2 型糖尿病患者相比，年轻人更有可能属于少数族裔：16 岁以下者占 51%，16-18 岁者占 41%，19-25 岁者占 38%，26-39 岁者占 38%，40-59 岁者占 27%，60-79 岁者占 15%。此外，40 岁以下的人更有可能肥胖、女性、居住在最贫困的社会经济地区，并且不太可能接受 NICE 推荐的年度护理流程或达到 HbA 目标。
大量年龄在 40 岁以下的 2 型糖尿病患者，更有可能具有与不平等相关的特征，且不太可能达到 HbA 目标并接受推荐的护理流程。这些发现突出表明，需要考虑为这一高风险群体提供新的服务提供方式。
