Glucose control and risk factors of macrovascular complications in early onset type 2 diabetes mellitus

Abstract

Objective To investigate the glycemic control and macrovascular complications risk factors in early onset type 2 diabetes mellitus(EDM). Methods This cross-sectional study included three groups: (1) EDM group, adults diagnosed with type 2 diabetes at 18-40 yeas of age (n=219). (2) Usual onset diabetes mellitus group as control DM group, adults diagnosed with type 2 diabetes older than 40 years (n= 1 036). (3) Age matched non- diabetic group (n=478). Body mass index(BMI), blood pressure, fasting glucose, glycated hemoglobin A1c(HbA1c), fasting insulin, high- density lipoprotein cholesterol(HDL- C), triglycerides and low- density lipoprotein cholesterol(LDL- C) were measured. For patients with diabetes mellitus, the complications were also examined. The t test and multivariate logistic regression analysis were used for statistical analysis. Results (1) The systolic and diastolic blood pressure was higher in EDM group than those in usual onset DM group ( t=2.685,2.560, all P <0.05). There were significantly higher smoking rate (χ2=5.439, P <0.05) and higher rate of insulin therapy (χ2=15.725, P<0.05) in EDM group than in control DM group.(2) In EDM group, 14.2% of them had HbA1c<7%. The prevalence rates of atherosclerotic plaque in arteries, diabetic retinopathy, neuropathy and positive micro-albuminuria were 50.7%, 52.5%, 53.4% and 53.0%, respectively. After adjusted age and gender, there were higher HbA1c levels ( F=3.733, P <0.05) and lower HbA1c control rate (χ2=8.508, P <0.05) of EDM group than control DM group. (3) Compared with the age matched non- diabetes group, the EDM group had higher levels of BMI ( t=3.623, P<0.05) , blood pressure (SBP t=16.392, P<0.001; DBP t=7.056, P<0.05) and LDL- C ( t=4.112, P<0.05). (4) In EDM group, women had a higher risk for arterial atherosclerosis than man ( OR=3.218, 95% CI: 1.527- 6.781). The postprandial 2 hour glucose and systolic blood pressure were also the risk factors for arterial atherosclerosis in EDM group ( OR=1.04, 95% CI: 1.016-1.072; OR=1.013, 95% CI:1.003-1.029 respectively). Conclusion Only 14.2% patients with early-onset diabetes meet the HbA1c control target and more than 50% patients already have macrovascular complications. In EDM patients, female, systolic blood pressure and postprandial 2 hour blood glucose are related with macrovascular complications. Key words: Diabetes mellitus, type 2; Early onset; Glycemia; Macrovascular complication; Risk factor