Correlates of Age Onset of Type 2 Diabetes Among Relatively Young Black and White Adults in a Community

Abstract

OBJECTIVEThe risk factors for middle-age onset of type 2 diabetes are well known. However, information is scant regarding the age onset of type 2 diabetes and its correlates in community-based black and white relatively young adults.RESEARCH DESIGN AND METHODSThis prospective cohort study consisted of normoglycemic (n = 2,459) and type 2 diabetic (n = 144) adults aged 18–50 years who were followed for an average of 16 years.RESULTSThe incidence rate of the onset of type 2 diabetes was 1.6, 4.3, 3.9, and 3.4 per 1,000 person-years for age-groups 18–29, 30–39, and 40–50 and total sample, respectively. Incidences of diabetes increased with age by race and sex groups (P for trend ≤0.01); higher in black females versus white females and blacks versus whites in total sample (P < 0.05). In a multivariable Cox model, baseline parental diabetes (hazard ratio [HR] 5.24) and plasma insulin were significantly associated with diabetes incidence at the youngest age (18–29 years); black race, BMI, and glucose at age 30–39 years; female sex, parental diabetes (HR 2.44), BMI, ratio of triglycerides and HDL cholesterol (TG/HDL-C ratio), and glucose at age 40–50 years; and black race, parental diabetes (HR 2.44), BMI, TG/HDL-C ratio, and glucose in whole cohort. Further, patients with diabetes, regardless of age onset, displayed a significantly higher prevalence of maternal history of diabetes at baseline (P < 0.01).CONCLUSIONSIn relatively young adults, predictability of baseline cardiometabolic risk factors along with race, sex, and parental history of diabetes for the onset of type 2 diabetes varied by age-group. These findings have implications for early prevention and intervention in relatively young adults.

Serum Amylin Indicates Hypertriglyceridemia in Pre-diabetics

“…Hypertriglyceridemia has been associated with increased insulin secretion in non-obese subjects, pre-diabetics [13,14], and patients with Type 2 Diabetes [15,16]. These results support the contention that hypertriglyceridemia may be related to amylin secretion.…”

The clinical characteristics at diagnosis of type 2 diabetes in a multi-ethnic population: the South London Diabetes cohort (SOUL-D)

“…Our data on those individuals eligible for SOUL-D but who declined to participate make it unlikely that this reflects only increased engagement in health: one contributor may be an increased tendency to obesity in black women [31]. BMI was significantly higher in white and black ethnic groups and in women, in keeping with the literature on metabolic syndrome and type 2 diabetes occurring at lower levels of overall obesity in South Asians [32], and concurring with the increased incidence of diabetes in black women in the 40-50 years age group [31]. The lipid profiles of our groups are also of interest.…”

Metabolic Syndrome: Bridging the Gap from Childhood to Adulthood

“…Sixteen-year-old follow-up from BHS reported that race, sex, and parental history of diabetes predict the early onset of T2DM [43]. Incidence of onset of diabetes was found to be greater in black-versus-white females and baseline parental history of diabetes was significantly associated with T2DM in age onset group 18-29.…”

“…Further, BHS indicates that the earlier onset of diabetes is associated with parental history (mother) of diabetes. This is before other morbidities compound the diagnosis and may be due to attrition of beta cells occur over time [43]. It is of interest in these studies a fasting glucose value of 86 mg/dL was found as a cut-point of being potentially abnormal (Table 1) [44].…”