Age Disparities Among Patients With Type 2 Diabetes and Associated Rates of Hospital Use and Diabetic Complications

Abstract

Introduction Although screening for diabetes is recommended at age 45, some populations may be at greater risk at earlier ages. Our objective was to quantify age disparities among patients with type 2 diabetes in New York City. Methods Using all-payer hospital claims data for New York City, we performed a cross-sectional analysis of patients with type 2 diabetes identified from emergency department visits during the 5-year period 2011–2015. We estimated type 2 diabetes prevalence at each year of life, the age distribution of patients stratified by decade, and the average age of patients by sex, race/ethnicity, and geographic location. Results We identified 576,306 unique patients with type 2 diabetes. These patients represented more than half of all people with type 2 diabetes in New York City. Patients in racial/ethnic minority groups were on average 5.5 to 8.4 years younger than non-Hispanic white patients. At age 45, type 2 diabetes prevalence was 10.9% among non-Hispanic black patients and 5.2% among non-Hispanic white patients. In our geospatial analyses, patients with type 2 diabetes were on average 6 years younger in hotspots of diabetes-related emergency department use and inpatient hospitalizations. The average age of patients with type 2 diabetes was also 1 to 2 years younger in hotspots of microvascular diabetic complications. Conclusion We identified profound age disparities among patients with type 2 diabetes in racial/ethnic minority groups and in neighborhoods with poor health outcomes. The younger age of these patients may be due to earlier onset of diabetes and/or earlier death from diabetic complications. Our findings demonstrate the need for geographically targeted interventions that promote earlier diagnosis and better glycemic control.

Clinical Characteristics and Factors Associated with In-Hospital Mortality in 66 755 Patients Hospitalized Due to Diabetes in Poland, January to December 2019

“…Findings from this study showed that more than three-fourths of patients hospitalized due to type 2 diabetes were more than 60 years of age. This finding aligns with data on diabetes-related hospital admission in other countries [ 6 , 37 , 38 ]. Between 2009 and 2019, the prevalence of comorbidities among patients with type 2 diabetes increased from 75.2% to 78.9% [ 23 ].…”

Geographic and demographic heterogeneity of SARS-CoV-2 diagnostic testing in Illinois, USA, March to December 2020

“…While elevated prevalence of comorbidities such as diabetes and hypertension increased the underlying infection fatality rate in in Black and Hispanic/Latino populations, the enormous difference in CFR in younger age groups in Mar-Jun 2020 is unlikely to be explained by comorbidities alone. For example, if diabetes prevalence at age 45 were around 5% in non-Hispanic Whites and 11% in non-Hispanic Blacks (20), and diabetes increased the risk of severe outcomes by around 60% (21), the disparity in diabetes prevalence would increase the CFR in the Black population ages 41-50 by approximately 10%. Yet in this age group, the relative risk of death given a case was almost 300% higher in the Black population compared to White in Mar-Apr 2020 [2.94 (95% CI: 1.72-5.03)].…”

Heritability Estimation and Environmental Risk Assessment for Type 2 Diabetes Mellitus in a Rural Region in Henan, China: Family-Based and Case-Control Studies

“…A survey of the prevalence of T2DM in 11 Asian cohorts found that the highest prevalence of T2DM was observed in the oldest age group (>70 years) in China, and among the age group 60-69 years in Singapore and India (22). Besides, the highest proportion of non-Hispanic blacks with T2DM was in their 50s, more than a decade earlier than non-Hispanic whites (23). It is worth noting that our results suggested that there was no significant statistical difference in the prevalence of T2DM between males and females, and the heredity of T2DM may not be related to sex.…”

“…A survey of the prevalence of T2DM in 11 Asian cohorts found that the highest prevalence of T2DM was observed in the oldest age group (>70 years) in China, and among the age group 60–69 years in Singapore and India ( 22 ). Besides, the highest proportion of non-Hispanic blacks with T2DM was in their 50s, more than a decade earlier than non-Hispanic whites ( 23 ).…”