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. 2025 Sep 15;16(9):108480.
doi: 10.4239/wjd.v16.i9.108480.

Income and wealth inequality is associated with young-onset type 2 diabetes

Fu-Shun Yen  1 , James Cheng-Chung Wei  2   3   4 , Yao-Min Hung  5 , Jia-Sin Liu  6 , Chii-Min Hwu  7   8 , Chih-Cheng Hsu  9   10   11
Affiliations

Income and wealth inequality is associated with young-onset type 2 diabetes

Fu-Shun Yen et al. World J Diabetes. .

Abstract

Background: There are only a few studies on the influence of economic inequalities on young-onset type 2 diabetes (T2D).

Aim: To examine the impact of different family incomes on the development of young-onset T2D.

Methods: We identified 7505336 young adults aged 20-39 years from the 2008 Taiwan National Health Insurance Research Database. The young adults were divided into low-income, middle-income, and high-income groups. Cox proportional hazards models were used to determine the risks of young-onset T2D and all-cause mortality in low-income and middle-income groups compared with the high-income group.

Results: With a mean follow-up of 8.0 years, the incidence rates of young-onset T2D were 3.39, 3.10, and 2.88 per 1000 person-years in the low-income, middle-income, and high-income groups, respectively. Compared with the high-income group, the risk of young-onset T2D was significantly higher in the low-income [adjusted hazard ratio (aHR) (95%CI): 1.46 (1.44-1.48)] and middle-income [aHR (95%CI): 1.29 (1.27-1.31)] groups. All-cause mortality was also higher in the low-income [aHR (95%CI): 2.79 (2.70-2.88)] and middle-income [aHR (95%CI): 1.59 (1.53-1.65)] groups. Older age, male sex, obesity, smoking, alcohol-related disorders, hypertension, dyslipidemia, gout, and psychotic disorders were significantly associated with increased risks of both young-onset T2D and mortality.

Conclusion: This nationwide cohort study demonstrated that young people from low-income and middle-income groups had a higher risk of youth-onset T2D and mortality than those from the high-income group.

Keywords: All-cause mortality; Family income; High-income; Low-income; Middle-income; Young-onset diabetes; Young-onset type 2 diabetes.

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Conflict of interest statement

Conflict-of-interest statement: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The case selection flowchart.
Figure 2
Figure 2
Kaplan-Meier curves illustrated the cumulative incidence of type 2 diabetes incidence in 20-39-year-olds.
Figure 3
Figure 3
Forest plots illustrating the risks of diabetes and mortality by income levels, stratified by sex and obesity. HR: Hazards ratio; CI: Confidence interval.
See this image and copyright information in PMC

References

    1. GBD 2021 Diabetes Collaborators. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023;402:203–234. - PMC - PubMed
    1. Ahmad E, Lim S, Lamptey R, Webb DR, Davies MJ. Type 2 diabetes. Lancet. 2022;400:1803–1820. - PubMed
    1. Yeung RO, Zhang Y, Luk A, Yang W, Sobrepena L, Yoon KH, Aravind SR, Sheu W, Nguyen TK, Ozaki R, Deerochanawong C, Tsang CC, Chan WB, Hong EG, Do TQ, Cheung Y, Brown N, Goh SY, Ma RC, Mukhopadhyay M, Ojha AK, Chakraborty S, Kong AP, Lau W, Jia W, Li W, Guo X, Bian R, Weng J, Ji L, Reyes-dela Rosa M, Toledo RM, Himathongkam T, Yoo SJ, Chow CC, Ho LL, Chuang LM, Tutino G, Tong PC, So WY, Wolthers T, Ko G, Lyubomirsky G, Chan JC. Metabolic profiles and treatment gaps in young-onset type 2 diabetes in Asia (the JADE programme): a cross-sectional study of a prospective cohort. Lancet Diabetes Endocrinol. 2014;2:935–943. - PubMed
    1. Lascar N, Brown J, Pattison H, Barnett AH, Bailey CJ, Bellary S. Type 2 diabetes in adolescents and young adults. Lancet Diabetes Endocrinol. 2018;6:69–80. - PubMed
    1. Chang CH, Shau WY, Jiang YD, Li HY, Chang TJ, Sheu WH, Kwok CF, Ho LT, Chuang LM. Type 2 diabetes prevalence and incidence among adults in Taiwan during 1999-2004: a national health insurance data set study. Diabet Med. 2010;27:636–643. - PubMed

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