Management of Early-Onset Type 2 Diabetes

Abstract

Early-onset type 2 diabetes is experiencing a rapid global increase, coinciding with the escalating rates of obesity. In contrast to diagnoses later in life, an earlier diagnosis is associated with unexplained excess risk of microvascular complications, adverse cardiovascular outcomes, and premature mortality. Patients with early-onset type 2 diabetes appear to undergo a more aggressive clinical course, which can be exacerbated by the limited availability of treatments. The heightened burden of complications places individuals with early-onset type 2 diabetes at a substantial risk of multimorbidity, underscoring the urgency for interventions to reverse these concerning trends. While the pathophysiology and interventions for adolescent-onset (< 19 years) type 2 diabetes within the early-onset cohort have received considerable attention in research, young adults aged 19~39 years (a larger proportion numerically) remain insufficiently characterized and are notably absent in the current evidence guiding management. Current management approaches derived from trials in later-onset type 2 diabetes may not be suited for this specific demographic. This review provides a comprehensive summary of recent findings related to early-onset type 2 diabetes, aiming to contribute valuable insights that could shape future strategies for prevention, diagnosis, and treatment.