RT Journal Article
SR Electronic
T1 Prevalence of Diabetes Complications in Adolescents With Type 2 Compared With Type 1 Diabetes
JF Diabetes Care
JO Diabetes Care
FD American Diabetes Association
SP 1300
OP 1306
DO 10.2337/dc05-2470
VO 29
IS 6
A1 Eppens, Maike C.
A1 Craig, Maria E.
A1 Cusumano, Janine
A1 Hing, Stephen
A1 Chan, Albert K.F.
A1 Howard, Neville J.
A1 Silink, Martin
A1 Donaghue, Kim C.
YR 2006
UL http://care.diabetesjournals.org/content/29/6/1300.abstract
AB OBJECTIVE—To compare the prevalence of diabetes complications and their risk factors in youth with type 1 versus type 2 diabetes. RESEARCH DESIGN AND METHODS—We performed a comparative clinic-based study of 1,433 patients with type 1 diabetes and 68 patients with type 2 diabetes aged <18 years from New South Wales, Australia. Retinopathy was assessed by seven-field stereoscopic retinal photography; albumin excretion rate from three consecutive, timed, overnight urine collections; peripheral neuropathy by thermal and vibration threshold; and autonomic neuropathy by pupillometry. HbA1c (A1C) and lipids were measured in all patients and C-peptide in patients with type 2 diabetes. RESULTS—In patients with type 1 versus type 2 diabetes, median (interquartile range) age was 15.7 years (13.9–17.0) and 15.3 years (13.6–16.4), respectively (P = 0.2), whereas median diabetes duration was 6.8 years (4.7–9.6) and 1.3 years (0.6–3.1), respectively (P < 0.0001). Retinopathy was significantly more common in patients with type 1 diabetes (20 vs. 4%, P = 0.04), while microalbuminuria and hypertension were significantly less common (6 and 16% in type 1 diabetes vs. 28 and 36% in type 2 diabetes). Rates of peripheral and autonomic neuropathy were similar (27 and 61% in type 1 diabetes vs. 21 and 57% in type 2 diabetes). In multivariate analyses, microalbuminuria was significantly associated with older age (odds ratio 1.3 [95% CI 1.2–1.5], P < 0.001) and systolic hypertension (3.63 [2.0–6.3], P < 0.001) in type 1 diabetes, while only higher A1C (1.7 [1.3–2.9], P = 0.002) was significant in patients with type 2 diabetes. CONCLUSIONS—Youth with type 2 diabetes have significantly higher rates of microalbuminuria and hypertension than their peers with type 1 diabetes, despite shorter diabetes duration and lower A1C. The results of this study support recommendations for early complications screening and aggressive targeting of glycemic control in patients with type 2 diabetes.