Initial Glycemic Control and Care Among Younger Adults Diagnosed With Type 2 Diabetes
Initial Glycemic Control and Care Among Younger Adults Diagnosed With Type 2 Diabetes
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DOI：
10.2337/dc19-1380
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发表时间：
2020-05-01
期刊：
影响因子：
16.2
通讯作者：
Grant, Richard W.
中科院分区：
文献类型：
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作者：
Gopalan, Anjali;Mishra, Pranita;Grant, Richard W.
目的：45岁以下成人中2型糖尿病的患病率正在增加。2型糖尿病的发病年龄越小，糖尿病相关并发症的风险就越高。考虑到早期血糖控制带来的持久益处，我们比较了年轻发病（21-44岁）和中年发病（45-64岁）的2型糖尿病成年人的血糖控制和初始护理。研究设计和方法使用来自大型综合医疗保健系统的数据，我们确定了32,137名成年人（年龄21-64岁）患有偶发糖尿病（首次HbA（1c）≥ 6.5% [>= 48 mmol/mol]）。我们排除了任何有2型糖尿病、妊娠糖尿病或1型糖尿病病史的患者。我们使用广义线性混合模型，调整人口统计学和临床变量，以检查1年时血糖控制和护理的差异。结果：在确定的个体中，26.4%的人患有老年起病的2型糖尿病，73.6%的人患有中年起病的2型糖尿病。年轻发病的成人初始平均HbA（1c）值（8.9% [74 mmol/mol]）高于中年发病的成人（8.4% [68 mmol/mol]）（P < 0.0001），达到HbA（1c）的几率较低
OBJECTIVE The prevalence of type 2 diabetes is increasing among adults under age 45. Onset of type 2 diabetes at a younger age increases an individual's risk for diabetes-related complications. Given the lasting benefits conferred by early glycemic control, we compared glycemic control and initial care between adults with younger onset (21-44 years) and mid-age onset (45-64 years) of type 2 diabetes. RESEARCH DESIGN AND METHODS Using data from a large, integrated health care system, we identified 32,137 adults (aged 21-64 years) with incident diabetes (first HbA(1c) >= 6.5% [>= 48 mmol/mol]). We excluded anyone with evidence of prior type 2 diabetes, gestational diabetes mellitus, or type 1 diabetes. We used generalized linear mixed models, adjusting for demographic and clinical variables, to examine differences in glycemic control and care at 1 year. RESULTS Of identified individuals, 26.4% had younger-onset and 73.6% had mid-age-onset type 2 diabetes. Adults with younger onset had higher initial mean HbA(1c) values (8.9% [74 mmol/mol]) than adults with onset in mid-age (8.4% [68 mmol/mol]) (P < 0.0001) and lower odds of achieving an HbA(1c)