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Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses – published online 14/12/2020

nanayakkara GA

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

Type 2 diabetes is increasingly diagnosed in younger adults; however, the relationship between age at diagnosis and diabetes complications is unclear. In this issue, Nanayakkara et al (https://doi.org/10.1007/s00125-020-05319-w) integrate data from 1.3 million individuals from 30 countries to conduct the first systematic review and meta-analyses exploring associations between age at diabetes diagnosis and subsequent complications. 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 authors propose that, over time, the effects of both ageing and diabetes duration may be compounded, resulting in premature complications and death in people diagnosed with type 2 diabetes at a younger age. Early and sustained interventions to optimise glycaemic control and cardiovascular risk profiles in those with established type 2 diabetes, and measures to delay the onset of type 2 diabetes in high-risk groups are crucial to reduce future diabetes-related morbidity and mortality.

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