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. 2022 May 2:15:1375-1387.
doi: 10.2147/DMSO.S354787. eCollection 2022.

Clinical Characteristics, Glycemic Control, and Microvascular Complications Compared Between Young-Onset Type 1 and Type 2 Diabetes Patients at Siriraj Hospital - A Tertiary Referral Center

Lukana Preechasuk  1 , Suchavadee Tantasuwan  2 , Supawadee Likitmaskul  1 , Jeerunda Santiprabhob  1   3 , Ornsuda Lertbannaphong  1   3 , Nattachet Plengvidhya  2   4 , Watip Tangjittipokin  4   5 , Wannee Nitiyanant  1   2 , Raweewan Lertwattanarak  1   2
Affiliations

Clinical Characteristics, Glycemic Control, and Microvascular Complications Compared Between Young-Onset Type 1 and Type 2 Diabetes Patients at Siriraj Hospital - A Tertiary Referral Center

Lukana Preechasuk et al. Diabetes Metab Syndr Obes. .

Abstract

Purpose: This study aimed to investigate the clinical characteristics, glycemic control, and microvascular complications compared between young-onset type 1 (T1DM) and type 2 diabetes (T2DM) patients at Siriraj Hospital.

Patients and methods: We collected demographic, clinical, glycemic control, and microvascular complication data of young-onset (onset <30 years of age) T1DM and T2DM patients at our center using February 2019-December 2020 data from the Thai Type 1 Diabetes and Diabetes diagnosed Age before 30 years Registry, Care and Network (T1DDAR CN).

Results: Of 396 patients, 76% had T1DM and 24% had T2DM. At diagnosis, T1DM were significantly younger (9.7±5.4 vs 16.9±6.4 years, p<0.001), had a lower body mass index (17.2±4.1 vs 30.8±7.9 kg/m2, p<0.001), higher prevalence of diabetic ketoacidosis (DKA) (66.1% vs 13.7%, p<0.001), and higher HbA1c level (12.8±2.6% vs 10.9±3.1%, p=0.002) compared to T2DM. Regarding glycemic control, the mean HbA1c at registry enrollment did not differ between groups (T1DM 8.3±1.8% vs T2DM 8.1±2.2%, p=0.303), but T1DM achieved HbA1c <7% significantly less than T2DM (19.3% vs 47.8%, p<0.001). T1DM showed deterioration of glycemic control during 10-20 years of age, and gradually improved during 20-30 years of age, whereas patients with T2DM showed progressive worsening of glycemic control over time. Concerning microvascular complications, the prevalence of diabetic retinopathy (10.6% vs 9%, p=0.92) and diabetic neuropathy (3.4% vs 5.5%, p=0.514) between T1DM and T2DM was not significantly different. However, T2DM had a significantly higher prevalence of diabetic nephropathy (T1DM 10.1% vs T2DM 40.2%, p<0.001) that developed within a significantly shorter duration of diabetes (T1DM 11.0±6.8 vs T2DM 4.3±5.1 years, p<0.001) compared to T1DM.

Conclusion: T1DM had a significantly high prevalence of DKA at presentation, and most T1DM did not achieve the glycemic target, especially during adolescence. T2DM had a significantly higher prevalence of diabetic nephropathy that developed within a shorter duration of diabetes compared to T1DM.

Keywords: Siriraj Hospital; Thailand; clinical characteristics; glycemic control; microvascular complications; young-onset type 1 and type 2 diabetes patients.

PubMed Disclaimer

Conflict of interest statement

All authors declare no personal or professional conflicts of interest, and no financial support from the companies that produce and/or distribute the drugs, devices, or materials described in this report.

Figures

Figure 1
Figure 1
Type of young-onset diabetes compared between genders among all included patients and stratified by age group.
Figure 2
Figure 2
Pancreatic antibody results in 238 patients with young-onset type 1 diabetes mellitus. Each patient underwent testing for 1, 2, or 3 different pancreatic antibodies according to the physician’s discretion.
Figure 3
Figure 3
Glycemic control compared between young-onset type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) patients. (A) Glycemic control among all T1DM and stratified by age group. (B) Glycemic control among all T2DM and stratified by age group. (C) Mean most recent glycated hemoglobin (HbA1c) level within 6 months compared between T1DM and T2DM and stratified by age group. (D) Mean most recent HbA1c level among T1DM patients stratified by frequency of self -monitoring of blood glucose (SMBG).
See this image and copyright information in PMC

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