Abstract

This study aims to determine the cumulative incidence of diabetes related complications following diabetes onset and to determine the independent effect of age at onset of diabetes on the risk of developing diabetes related complications. All patients with diabetes diagnosed in 2007 or later were included from a multi-regional health systems database. Diabetes complications were categorized into: Renal complications Cardiovascular disease (CVD) Eye complications Stroke Skin/Peripheral Vascular Disease/Neuropathy Complications were grouped into the above categories based on the Chronic Disease Management Database (CDMD) dictionary classifications. Patients were followed up to the development of the complication, death or were deemed alive as on 31/12/2014 (end of follow up) After adjusting for mean HbA1c, demographics and co-morbidities, patients aged ≥ 65 years had hazard ratios of 1.92, 1.47, 1.44, 3.36 and 3.53 for developing renal, eye, skin/Peripheral vascular disease/neuropathy, CVD and stroke respectively compared to patients aged <40 years. The 1, 5 and 8 year disease free survival for all five complications were lowest for the ≥ 65 years category patients compared to patients <40 years and 40-64 years. Cumulative incidence of diabetes related complications was significantly higher for patients with a late age at onset. Later age at onset of diabetes was significantly associated with diabetes related complications independent of HbA1c, ethnicity, gender and co-morbidities. Mean time (conditional) to a diabetes complication was not too high for the <40 years group compared to the ≥ 65 years group. Longer follow up is needed to determine the true median time to event for each complication.

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