Tibballs Katrina Louise Bø, Kirkebøen Lars, Jenum Anne Karen, Straand Jørund, Berg Tore Julsrud, Buhl Esben Selmer
Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
Statistics Norway, Oslo, Norway.
BMJ Open. 2025 Sep 4;15(9):e096521. doi: 10.1136/bmjopen-2024-096521.
Young-onset type 2 diabetes (YOD), diagnosed before 40 years of age, entails a high disease burden and potential for early dependence on disability benefits. The risk of type 2 diabetes (T2D) varies with socio-economic status and ethnic background, yet the relationship between these factors and age at diagnosis is insufficiently explored. We aimed to study associations between YOD and living on disability benefits, educational level and country background.
Cross-sectional data on 8640 individuals with T2D, linked to data on educational level and country background, were compared with population data from the same residential areas. Similar comparisons were made for data on disability benefits among 3854 individuals of working age (<65 years). Using negative binomial regression, we analysed risk of disability by age at diabetes diagnosis, and risk of YOD by educational level and country background.
The risk of being dependent on disability benefits was three times higher in YOD (adjusted incidence rate ratio, aIRR (95% CI) 3.1 (2.7 to 3.5)) and twice as high in later-onset T2D (1.9 (1.8 to 2.1)) as in the general population. People of Norwegian background with low educational levels had threefold higher YOD risk (3.3 (2.4 to 4.4)) than those with a tertiary degree, while people of non-Western backgrounds with low educational levels had a smaller increase in YOD risk (1.5 (1.1 to 2.1)). People of non-Western backgrounds had higher YOD risk than those of Norwegian background (4.2 (3.5 to 5.0)), while people of south Asian background had an even greater relative YOD risk (9.0 (7.3 to 11.0)), threefold higher than for later-onset T2D (3.2 (2.8 to 3.7)).
Lifetime risk of being dependent on disability benefits was substantially higher for individuals with YOD than in later onset T2D. Non-Western and particularly south Asian backgrounds were associated with increased YOD risk. Low education was an important YOD risk factor only for people with Norwegian background.
早发型2型糖尿病（YOD）是指在40岁之前被诊断出的糖尿病，其疾病负担较重，且患者有较早依赖残疾福利的可能性。2型糖尿病（T2D）的风险因社会经济地位和种族背景而异，但这些因素与确诊年龄之间的关系尚未得到充分研究。我们旨在研究早发型2型糖尿病与领取残疾福利、教育水平和国家背景之间的关联。
将8640例2型糖尿病患者的横断面数据与教育水平和国家背景数据相联系，并与来自相同居住地区的人口数据进行比较。对3854名工作年龄（<65岁）人群的残疾福利数据进行了类似的比较。我们使用负二项回归分析了糖尿病确诊年龄与残疾风险之间的关系，以及教育水平和国家背景与早发型2型糖尿病风险之间的关系。
早发型2型糖尿病患者依赖残疾福利的风险比普通人群高3倍（调整发病率比，aIRR（95%CI）3.1（2.7至3.5）），晚发型2型糖尿病患者的这一风险是普通人群的2倍（1.9（1.8至2.1））。教育水平低的挪威裔人群患早发型2型糖尿病的风险是拥有高等学位人群的3倍（3.3（2.4至4.4）），而教育水平低的非西方背景人群患早发型2型糖尿病的风险增幅较小（1.5（1.1至2.1））。非西方背景人群患早发型2型糖尿病的风险高于挪威裔人群（4.2（3.5至5.0）），而南亚背景人群患早发型2型糖尿病的相对风险更高（9.0（7.3至11.0）），是晚发型2型糖尿病患者的3倍（3.2（2.8至3.7））。
早发型2型糖尿病患者一生依赖残疾福利的风险显著高于晚发型2型糖尿病患者。非西方背景尤其是南亚背景与早发型2型糖尿病风险增加有关。低教育水平仅是挪威裔人群患早发型2型糖尿病的一个重要风险因素。
