Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses
Aims/hypothesis Few studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise the risk of mortality, macrovascular complications and microvascular complications associated with age at diagnosis of type 2 diabetes. Methods...
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| Vydáno v: | Diabetologia Ročník 64; číslo 2; s. 275 - 287 |
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| Hlavní autoři: | , , , , , , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.02.2021
Springer Nature B.V |
| Témata: | |
| ISSN: | 0012-186X, 1432-0428, 1432-0428 |
| On-line přístup: | Získat plný text |
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| Abstract | Aims/hypothesis
Few studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise the risk of mortality, macrovascular complications and microvascular complications associated with age at diagnosis of type 2 diabetes.
Methods
Data were sourced from MEDLINE and All EBM (Evidence Based Medicine) databases from inception to July 2018. Observational studies, investigating the effect of age at diabetes diagnosis on macrovascular and microvascular diabetes complications in adults with type 2 diabetes were selected according to pre-specified criteria. Two investigators independently extracted data and evaluated all studies. If data were not reported in a comparable format, data were obtained from authors, presented as minimally adjusted ORs (and 95% CIs) per 1 year increase in age at diabetes diagnosis, adjusted for current age for each outcome of interest. The study protocol was recorded with PROSPERO International Prospective Register of Systematic Reviews (CRD42016043593).
Results
Data from 26 observational studies comprising 1,325,493 individuals from 30 countries were included. Random-effects meta-analyses with inverse variance weighting were used to obtain the pooled ORs. Age at diabetes diagnosis was inversely associated with risk of all-cause mortality and macrovascular and microvascular disease (all
p
< 0.001). Each 1 year increase in age at diabetes diagnosis was associated with a 4%, 3% and 5% decreased risk of all-cause mortality, macrovascular disease and microvascular disease, respectively, adjusted for current age. The effects were consistent for the individual components of the composite outcomes (all
p
< 0.001).
Conclusions/interpretation
Younger, rather than older, age at diabetes diagnosis was associated with higher risk of mortality and vascular disease. Early and sustained interventions to delay type 2 diabetes onset and improve blood glucose levels and cardiovascular risk profiles of those already diagnosed are essential to reduce morbidity and mortality.
Graphical abstract |
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| AbstractList | Few studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise the risk of mortality, macrovascular complications and microvascular complications associated with age at diagnosis of type 2 diabetes.
Data were sourced from MEDLINE and All EBM (Evidence Based Medicine) databases from inception to July 2018. Observational studies, investigating the effect of age at diabetes diagnosis on macrovascular and microvascular diabetes complications in adults with type 2 diabetes were selected according to pre-specified criteria. Two investigators independently extracted data and evaluated all studies. If data were not reported in a comparable format, data were obtained from authors, presented as minimally adjusted ORs (and 95% CIs) per 1 year increase in age at diabetes diagnosis, adjusted for current age for each outcome of interest. The study protocol was recorded with PROSPERO International Prospective Register of Systematic Reviews (CRD42016043593).
Data from 26 observational studies comprising 1,325,493 individuals from 30 countries were included. Random-effects meta-analyses with inverse variance weighting were used to obtain the pooled ORs. Age at diabetes diagnosis was inversely associated with risk of all-cause mortality and macrovascular and microvascular disease (all p < 0.001). Each 1 year increase in age at diabetes diagnosis was associated with a 4%, 3% and 5% decreased risk of all-cause mortality, macrovascular disease and microvascular disease, respectively, adjusted for current age. The effects were consistent for the individual components of the composite outcomes (all p < 0.001).
Younger, rather than older, age at diabetes diagnosis was associated with higher risk of mortality and vascular disease. Early and sustained interventions to delay type 2 diabetes onset and improve blood glucose levels and cardiovascular risk profiles of those already diagnosed are essential to reduce morbidity and mortality. Graphical abstract. Aims/hypothesisFew studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise the risk of mortality, macrovascular complications and microvascular complications associated with age at diagnosis of type 2 diabetes.MethodsData were sourced from MEDLINE and All EBM (Evidence Based Medicine) databases from inception to July 2018. Observational studies, investigating the effect of age at diabetes diagnosis on macrovascular and microvascular diabetes complications in adults with type 2 diabetes were selected according to pre-specified criteria. Two investigators independently extracted data and evaluated all studies. If data were not reported in a comparable format, data were obtained from authors, presented as minimally adjusted ORs (and 95% CIs) per 1 year increase in age at diabetes diagnosis, adjusted for current age for each outcome of interest. The study protocol was recorded with PROSPERO International Prospective Register of Systematic Reviews (CRD42016043593).ResultsData from 26 observational studies comprising 1,325,493 individuals from 30 countries were included. Random-effects meta-analyses with inverse variance weighting were used to obtain the pooled ORs. Age at diabetes diagnosis was inversely associated with risk of all-cause mortality and macrovascular and microvascular disease (all p < 0.001). Each 1 year increase in age at diabetes diagnosis was associated with a 4%, 3% and 5% decreased risk of all-cause mortality, macrovascular disease and microvascular disease, respectively, adjusted for current age. The effects were consistent for the individual components of the composite outcomes (all p < 0.001).Conclusions/interpretationYounger, rather than older, age at diabetes diagnosis was associated with higher risk of mortality and vascular disease. Early and sustained interventions to delay type 2 diabetes onset and improve blood glucose levels and cardiovascular risk profiles of those already diagnosed are essential to reduce morbidity and mortality. Few studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise the risk of mortality, macrovascular complications and microvascular complications associated with age at diagnosis of type 2 diabetes.AIMS/HYPOTHESISFew studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise the risk of mortality, macrovascular complications and microvascular complications associated with age at diagnosis of type 2 diabetes.Data were sourced from MEDLINE and All EBM (Evidence Based Medicine) databases from inception to July 2018. Observational studies, investigating the effect of age at diabetes diagnosis on macrovascular and microvascular diabetes complications in adults with type 2 diabetes were selected according to pre-specified criteria. Two investigators independently extracted data and evaluated all studies. If data were not reported in a comparable format, data were obtained from authors, presented as minimally adjusted ORs (and 95% CIs) per 1 year increase in age at diabetes diagnosis, adjusted for current age for each outcome of interest. The study protocol was recorded with PROSPERO International Prospective Register of Systematic Reviews (CRD42016043593).METHODSData were sourced from MEDLINE and All EBM (Evidence Based Medicine) databases from inception to July 2018. Observational studies, investigating the effect of age at diabetes diagnosis on macrovascular and microvascular diabetes complications in adults with type 2 diabetes were selected according to pre-specified criteria. Two investigators independently extracted data and evaluated all studies. If data were not reported in a comparable format, data were obtained from authors, presented as minimally adjusted ORs (and 95% CIs) per 1 year increase in age at diabetes diagnosis, adjusted for current age for each outcome of interest. The study protocol was recorded with PROSPERO International Prospective Register of Systematic Reviews (CRD42016043593).Data from 26 observational studies comprising 1,325,493 individuals from 30 countries were included. Random-effects meta-analyses with inverse variance weighting were used to obtain the pooled ORs. Age at diabetes diagnosis was inversely associated with risk of all-cause mortality and macrovascular and microvascular disease (all p < 0.001). Each 1 year increase in age at diabetes diagnosis was associated with a 4%, 3% and 5% decreased risk of all-cause mortality, macrovascular disease and microvascular disease, respectively, adjusted for current age. The effects were consistent for the individual components of the composite outcomes (all p < 0.001).RESULTSData from 26 observational studies comprising 1,325,493 individuals from 30 countries were included. Random-effects meta-analyses with inverse variance weighting were used to obtain the pooled ORs. Age at diabetes diagnosis was inversely associated with risk of all-cause mortality and macrovascular and microvascular disease (all p < 0.001). Each 1 year increase in age at diabetes diagnosis was associated with a 4%, 3% and 5% decreased risk of all-cause mortality, macrovascular disease and microvascular disease, respectively, adjusted for current age. The effects were consistent for the individual components of the composite outcomes (all p < 0.001).Younger, rather than older, age at diabetes diagnosis was associated with higher risk of mortality and vascular disease. Early and sustained interventions to delay type 2 diabetes onset and improve blood glucose levels and cardiovascular risk profiles of those already diagnosed are essential to reduce morbidity and mortality. Graphical abstract.CONCLUSIONS/INTERPRETATIONYounger, rather than older, age at diabetes diagnosis was associated with higher risk of mortality and vascular disease. Early and sustained interventions to delay type 2 diabetes onset and improve blood glucose levels and cardiovascular risk profiles of those already diagnosed are essential to reduce morbidity and mortality. Graphical abstract. Aims/hypothesis Few studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise the risk of mortality, macrovascular complications and microvascular complications associated with age at diagnosis of type 2 diabetes. Methods Data were sourced from MEDLINE and All EBM (Evidence Based Medicine) databases from inception to July 2018. Observational studies, investigating the effect of age at diabetes diagnosis on macrovascular and microvascular diabetes complications in adults with type 2 diabetes were selected according to pre-specified criteria. Two investigators independently extracted data and evaluated all studies. If data were not reported in a comparable format, data were obtained from authors, presented as minimally adjusted ORs (and 95% CIs) per 1 year increase in age at diabetes diagnosis, adjusted for current age for each outcome of interest. The study protocol was recorded with PROSPERO International Prospective Register of Systematic Reviews (CRD42016043593). Results Data from 26 observational studies comprising 1,325,493 individuals from 30 countries were included. Random-effects meta-analyses with inverse variance weighting were used to obtain the pooled ORs. Age at diabetes diagnosis was inversely associated with risk of all-cause mortality and macrovascular and microvascular disease (all p < 0.001). Each 1 year increase in age at diabetes diagnosis was associated with a 4%, 3% and 5% decreased risk of all-cause mortality, macrovascular disease and microvascular disease, respectively, adjusted for current age. The effects were consistent for the individual components of the composite outcomes (all p < 0.001). Conclusions/interpretation Younger, rather than older, age at diabetes diagnosis was associated with higher risk of mortality and vascular disease. Early and sustained interventions to delay type 2 diabetes onset and improve blood glucose levels and cardiovascular risk profiles of those already diagnosed are essential to reduce morbidity and mortality. Graphical abstract |
| Author | Pavkov, Meda E. Owens, David R. Thomas, Rebecca L. Luk, Andrea O.-Y. Zoungas, Sophia Romero-Aroca, Pedro Nanayakkara, Natalie Chan, Juliana C.-N. Amutha, Anandakumar Heritier, Stephane Mohan, Viswanathan Teede, Helena J. Wong, Jencia Curtis, Andrea J. Magliano, Dianna J. Chalmers, John Gasevic, Danijela Ji, Linong Penno, Giuseppe Song, Soon Kenealy, Timothy Gadowski, Adelle M. |
| Author_xml | – sequence: 1 givenname: Natalie orcidid: 0000-0001-9271-9917 surname: Nanayakkara fullname: Nanayakkara, Natalie organization: School Public Health and Preventive Medicine, Monash University, Baker Heart and Diabetes Institute – sequence: 2 givenname: Andrea J. orcidid: 0000-0003-2407-770X surname: Curtis fullname: Curtis, Andrea J. organization: School Public Health and Preventive Medicine, Monash University – sequence: 3 givenname: Stephane orcidid: 0000-0002-3640-079X surname: Heritier fullname: Heritier, Stephane organization: School Public Health and Preventive Medicine, Monash University – sequence: 4 givenname: Adelle M. orcidid: 0000-0003-3298-4414 surname: Gadowski fullname: Gadowski, Adelle M. organization: School Public Health and Preventive Medicine, Monash University – sequence: 5 givenname: Meda E. orcidid: 0000-0002-6203-1772 surname: Pavkov fullname: Pavkov, Meda E. organization: Centers for Disease Control and Prevention, Division for Diabetes Translation – sequence: 6 givenname: Timothy orcidid: 0000-0001-6002-4766 surname: Kenealy fullname: Kenealy, Timothy organization: Department of Medicine, University of Auckland – sequence: 7 givenname: David R. orcidid: 0000-0003-1002-1238 surname: Owens fullname: Owens, David R. organization: Diabetes Research Group, Swansea University Medical School – sequence: 8 givenname: Rebecca L. orcidid: 0000-0002-2970-6352 surname: Thomas fullname: Thomas, Rebecca L. organization: Diabetes Research Group, Swansea University Medical School – sequence: 9 givenname: Soon orcidid: 0000-0001-5316-1797 surname: Song fullname: Song, Soon organization: Department of Diabetes, Northern General Hospital – sequence: 10 givenname: Jencia orcidid: 0000-0003-0321-9553 surname: Wong fullname: Wong, Jencia organization: Royal Prince Alfred Hospital – sequence: 11 givenname: Juliana C.-N. orcidid: 0000-0003-1325-1194 surname: Chan fullname: Chan, Juliana C.-N. organization: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region – sequence: 12 givenname: Andrea O.-Y. orcidid: 0000-0002-5244-6069 surname: Luk fullname: Luk, Andrea O.-Y. organization: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region – sequence: 13 givenname: Giuseppe orcidid: 0000-0002-2834-4847 surname: Penno fullname: Penno, Giuseppe organization: Diabetes and Metabolic Disease Section, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Pisana University of Pisa – sequence: 14 givenname: Linong orcidid: 0000-0002-3262-2168 surname: Ji fullname: Ji, Linong organization: Department of Endocrinology, Peking University People’s Hospital – sequence: 15 givenname: Viswanathan orcidid: 0000-0001-5038-6210 surname: Mohan fullname: Mohan, Viswanathan organization: Madras Diabetes Research Foundation & Dr Mohan’s Diabetes Specialities Centre – sequence: 16 givenname: Anandakumar orcidid: 0000-0002-9974-889X surname: Amutha fullname: Amutha, Anandakumar organization: Madras Diabetes Research Foundation & Dr Mohan’s Diabetes Specialities Centre – sequence: 17 givenname: Pedro orcidid: 0000-0002-7061-8987 surname: Romero-Aroca fullname: Romero-Aroca, Pedro organization: Hospital Universtario Sant Joan – sequence: 18 givenname: Danijela orcidid: 0000-0001-5976-4011 surname: Gasevic fullname: Gasevic, Danijela email: danijela.gasevic@monash.edu organization: School Public Health and Preventive Medicine, Monash University, Usher Institute, University of Edinburgh, Old Medical School – sequence: 19 givenname: Dianna J. orcidid: 0000-0002-9507-6096 surname: Magliano fullname: Magliano, Dianna J. organization: School Public Health and Preventive Medicine, Monash University, Baker Heart and Diabetes Institute – sequence: 20 givenname: Helena J. orcidid: 0000-0001-7609-577X surname: Teede fullname: Teede, Helena J. organization: Monash Centre for Health Research and Implementation, Monash University – sequence: 21 givenname: John orcidid: 0000-0002-9931-0580 surname: Chalmers fullname: Chalmers, John organization: The George Institute for Global Health – sequence: 22 givenname: Sophia orcidid: 0000-0003-2672-0949 surname: Zoungas fullname: Zoungas, Sophia email: sophia.zoungas@monash.edu organization: School Public Health and Preventive Medicine, Monash University, The George Institute for Global Health |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33313987$$D View this record in MEDLINE/PubMed |
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| Keywords | Prognosis Age of onset Diabetes complications Diabetes mellitus, type 2 Disease progression Systematic review Diabetes Age factors Meta-analysis |
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| License | Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
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Few studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise... Few studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise the risk of... Aims/hypothesisFew studies examine the association between age at diagnosis and subsequent complications from type 2 diabetes. This paper aims to summarise the... |
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| SubjectTerms | Age Age of Onset Cardiovascular diseases Cerebrovascular Disorders - epidemiology Cerebrovascular Disorders - etiology Coronary Disease - epidemiology Coronary Disease - etiology Diabetes Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - diagnosis Diabetic Angiopathies - epidemiology Diabetic Angiopathies - etiology Diabetic Nephropathies - epidemiology Diabetic Nephropathies - etiology Diabetic Neuropathies - epidemiology Diabetic Neuropathies - etiology Diabetic Retinopathy - epidemiology Diabetic Retinopathy - etiology Diagnosis Evidence-based medicine Human Physiology Humans Internal Medicine Medical diagnosis Medical prognosis Medicine Medicine & Public Health Meta-analysis Metabolic Diseases Microvasculature Morbidity Mortality Odds Ratio Peripheral Vascular Diseases - epidemiology Peripheral Vascular Diseases - etiology Vascular diseases |
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| Title | Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses |
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