Age-, sex- and ethnicity-related differences in body weight, blood pressure, HbA1c and lipid levels at the diagnosis of type 2 diabetes relative to people without diabetes

Abstract

Aims/hypothesis: The aim of this work was to determine how weight patterns together with blood glucose, BP and lipids vary at diagnosis of diabetes by age, sex and ethnicity.

Methods: Using the UK Clinical Practice Research Datalink, we identified people with type 2 diabetes (n = 187,601) diagnosed in 1998-2015 and compared their weights, HbA_1c, BP and lipid levels at diagnosis with age-matched people without diabetes (n = 906,182), by sex and ethnic group.

Results: Younger age at diagnosis was associated with greater adjusted mean difference (95% CI) in weight between those with vs without type 2 diabetes: 18.7 (18.3, 19.1) kg at age 20-39 years and 5.3 (5.0, 5.5) kg at age ≥ 80 years. Weight differentials were maximal in white women, and were around double in white people compared with South Asian and black people. Despite lower absolute values, BP differences were also greater at younger age of diabetes onset: 7 (6, 7) mmHg at age 20-39 years vs -0.5 (-0.9, -0.2) at age ≥ 80 years. BP differences were greatest in white people, and especially in women. Triacylglycerol level differences were greatest in younger men. Finally, HbA_1c levels were also higher with younger onset diabetes, particularly in black people.

Conclusions/interpretation: At diagnosis of type 2 diabetes, when compared with people without diabetes, weight and BP differentials were greater in younger vs older people, in women vs men and in white vs South Asian and black people. These differences were observed even though South Asian and black people tend to develop diabetes a decade earlier with either similar or greater dysglycaemia. These striking patterns may have implications for management and prevention. Graphical abstract.

Keywords: Age; Blood pressure; Ethnicity; HbA1c; Sex; Weight.

Graphical abstract

Fig. 1

Age distribution at diagnosis of type 2 diabetes by sex (a) and ethnicity (b)

Fig. 2

(a–d) Adjusted age-specific mean (95% CI) differences in BMI (a), weight (b), systolic BP (c) and triacylglycerol level (d) in men and women recently diagnosed with type 2 diabetes compared with men and women without diabetes. (e) Age-specific mean HbA_1c levels in men and women recently diagnosed with type 2 diabetes

Fig. 3

Adjusted age-specific mean (95% CI) differences in BMI (a), weight (b), systolic BP (c) and triacylglycerol level (d) in white, South Asian and black people recently diagnosed with type 2 diabetes compared with people without diabetes. (e) Age-specific mean HbA_1c levels in white, South Asian and black people recently diagnosed with type 2 diabetes ≥ m²