Lee Clare J, Bergman Brandon K, Gou Ray, Williamson Suzanne, Boye Kristina S
Eli Lilly and Company, Indianapolis, IN, USA.
Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA.
Diabetes Ther. 2025 Sep 16. doi: 10.1007/s13300-025-01788-7.
Early onset type 2 diabetes (T2D), diagnosed before age 40 years, is potentially more aggressive than later-onset disease and is increasing in prevalence globally. We examined the prevalence of early onset T2D in the USA and characterised this population.
Data from the longitudinal series of NHANES cross-sectional surveys conducted between 1999 and 2020 were analysed retrospectively. The prevalence of diagnosed and undiagnosed early onset T2D was estimated across this period and the demographics, clinical characteristics and frequency of comorbidities in this population were described. Findings were compared with the US later-onset T2D population during the same period.
The prevalence of diagnosed and undiagnosed early onset T2D increased from 1.42% (standard error 0.19) and 0.18% (0.09), respectively, during the 1999-2000 survey cycle to 1.72% (0.24) and 0.35% (0.06), respectively, during the 2017-2020 cycle. Compared with those with later-onset disease, participants with early onset T2D had a lower mean poverty-income ratio, were more likely to be Hispanic or have no health insurance and less likely to be non-Hispanic white or have private or Medicare insurance (all p < 0.05). Individuals with early onset T2D generally had a worse cardiometabolic profile, with higher mean glycated haemoglobin, Homeostatic Model Assessment for Insulin Resistance score, fasting insulin and glucose, body mass index and waist circumference but were less likely to have congestive heart failure, coronary heart disease, stroke, chronic kidney disease or cancer (all p < 0.05). All comparisons remained statistically significant after adjustment for T2D duration among participants with diagnosed T2D.
These findings suggest that early onset T2D may disproportionately affect underserved populations with a higher likelihood of having cardiometabolic risk factors, suggesting a more aggressive disease that warrants the need for better diagnoses and treatment. Further research is needed to explore the potential link between cardiometabolic profile, risk of complications and longer-term cardiovascular outcomes in people with early onset T2D.
早发型2型糖尿病（T2D）是指在40岁之前被诊断出的糖尿病，其病情可能比晚发型更具侵袭性，且在全球范围内的患病率正在上升。我们调查了美国早发型T2D的患病率，并对这一人群进行了特征分析。
对1999年至2020年期间进行的美国国家健康与营养检查调查（NHANES）纵向系列横断面调查数据进行回顾性分析。在此期间估算已诊断和未诊断的早发型T2D的患病率，并描述该人群的人口统计学特征、临床特征和合并症发生频率。将研究结果与同期美国晚发型T2D人群进行比较。
在1999 - 2000年调查周期中，已诊断和未诊断的早发型T2D患病率分别为1.42%（标准误0.19）和0.18%（0.09），而在2017 - 2020年周期中分别升至1.72%（0.24）和0.35%（0.06）。与晚发型疾病患者相比，早发型T2D患者的平均贫困收入比更低，更有可能是西班牙裔或没有医疗保险，而非西班牙裔白人或拥有私人保险或医疗保险的可能性更小（所有p值均<0.05）。早发型T2D患者的心脏代谢状况通常更差，糖化血红蛋白、胰岛素抵抗稳态模型评估得分、空腹胰岛素和血糖、体重指数和腰围的平均值更高，但发生充血性心力衰竭、冠心病、中风、慢性肾病或癌症的可能性更小（所有p值均<0.05）。在对已诊断T2D患者的T2D病程进行调整后，所有比较结果仍具有统计学意义。
这些发现表明，早发型T2D可能对服务不足的人群影响更大，这些人群具有心脏代谢危险因素的可能性更高，提示这是一种更具侵袭性的疾病，需要更好的诊断和治疗。需要进一步研究来探索早发型T2D患者的心脏代谢状况、并发症风险和长期心血管结局之间的潜在联系。
