Premature Mortality and Comorbidities in Young-onset Diabetes: A 7-Year Prospective Analysis

Chan, Juliana C.N.; Lau, Eric S. H.; Luk, Andrea; Cheung, Karen; Kong, Alice Pik Shan; Yu, Lie; Choi, Kai Chow; Chow, Francis C. C.; Ozaki, Risa; Brown, Nicola; Yang, Xilin; Bennett, Peter H.; Ma, Rong; So, Wing‐Yee

doi:10.1016/j.amjmed.2014.03.018

Cited by 119 publications

(98 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Given rapidly increasing diabetes incidence in younger age groups 18 and the demographic, clinical, and prognostic differences in patients who develop diabetes in middle versus older age, 19,20 we also examined whether age (comparing those younger than 65 versus those older than 65) modified the risk of all-cause dementia in this population.…”

Section: Introductionmentioning

confidence: 99%

Effect of Depression and Diabetes Mellitus on the Risk for Dementia

et al. 2015

View full text Add to dashboard Cite

IMPORTANCE Although depression and type 2 diabetes mellitus (DM) may independently increase the risk for dementia, no studies have examined whether the risk for dementia among people with comorbid depression and DM is higher than the sum of each exposure individually.OBJECTIVE To examine the risk for all-cause dementia among persons with depression, DM, or both compared with persons with neither exposure. DESIGN, SETTING, AND PARTICIPANTSWe performed a national population-based cohort study of 2 454 532 adults, including 477 133 (19.4%) with depression, 223 174 (9.1%) with DM, and 95 691 (3.9%) with both. We included all living Danish citizens 50 years or older who were free of dementia from January 1, 2007, through December 31, 2013 (followed up through December 31, 2013). Dementia was ascertained by physician diagnosis from the Danish National Patient Register or the Danish Psychiatric Central Register and/or by prescription of a cholinesterase inhibitor or memantine hydrochloride from the Danish National Prescription Registry. Depression was ascertained by psychiatrist diagnosis from the Danish Psychiatric Central Research Register or by prescription of an antidepressant from the Danish National Prescription Registry. Diabetes mellitus was identified using the National Diabetes Register. MAIN OUTCOMES AND MEASURESWe estimated the risk for all-cause dementia associated with DM, depression, or both using Cox proportional hazards regression models that adjusted for potential confounding factors (eg, demographics) and potential intermediates (eg, medical comorbidities).RESULTS During 13 834 645 person-years of follow-up, 59 663 participants (2.4%) developed dementia; of these, 6466 (10.8%) had DM, 15 729 (26.4%) had depression, and 4022 (6.7%) had both. The adjusted hazard ratio for developing all-cause dementia was 1.83 (95% CI, 1.80-1.87) for persons with depression, 1.20 (95% CI, 1.17-1.23) for persons with DM, and 2.17 (95% CI, 2.10-2.24) for those with both compared with persons who had neither exposure. The excess risk for all-cause dementia observed for individuals with comorbid depression and DM surpassed the summed risk associated with each exposure individually, especially for persons younger than 65 years (hazard ratio, 4.84 [95% CI,). The corresponding attributable proportion due to the interaction of comorbid depression and DM was 0.25 (95% CI, 0.13-0.36; P < .001) for those younger than 65 years and 0.06 (95% CI, 0.02-0.10; P = .001) for those 65 years or older.CONCLUSIONS AND RELEVANCE Depression and DM were independently associated with a greater risk for dementia, and the combined association of both exposures with the risk for all-cause dementia was stronger than the additive association.

show abstract

Section: Introductionmentioning

confidence: 99%

Effect of Depression and Diabetes Mellitus on the Risk for Dementia

et al. 2015

View full text Add to dashboard Cite

show abstract

“…In the Joint Asia Diabetes Evaluation (JADE) program, among 41,029 patients recruited from across nine countries/regions in Asia, 18% had onset of T2DM below the age of 40 (97), had longer disease duration, and had higher rates of retinopathy and end-stage renal disease than those with onset of diabetes after the age of 40 (97). In the Hong Kong Diabetes Registry, patients with young-onset diabetes had higher risks of incident cardiovascular and renal complications at any age, driven by the longer disease duration (98). Given the proportion of patients with youngonset T2DM, the potential burden of diabetes-related complications is of great concern.…”

Section: Pattern Of Diabetes Complications In Asia and Pacific Communmentioning

confidence: 99%

Diabetes in Asia and the Pacific: Implications for the Global Epidemic

et al. 2016

Self Cite

View full text Add to dashboard Cite

The last three decades have witnessed an epidemic rise in the number of people with diabetes, especially type 2 diabetes, and particularly in developing countries, where more than 80% of the people with diabetes live. The rise of type 2 diabetes in South Asia is estimated to be more than 150% between 2000 and 2035. Although aging, urbanization, and associated lifestyle changes are the major determinants for the rapid increase, an adverse intrauterine environment and the resulting epigenetic changes could also contribute in many developing countries. The International Diabetes Federation estimated that there were 382 million people with diabetes in 2013, a number surpassing its earlier predictions. More than 60% of the people with diabetes live in Asia, with almost one-half in China and India combined. The Western Pacific, the world’s most populous region, has more than 138.2 million people with diabetes, and the number may rise to 201.8 million by 2035. The scenario poses huge social and economic problems to most nations in the region and could impede national and, indeed, global development. More action is required to understand the drivers of the epidemic to provide a rationale for prevention strategies to address the rising global public health “tsunami.” Unless drastic steps are taken through national prevention programs to curb the escalating trends in all of the countries, the social, economic, and health care challenges are likely to be insurmountable.

show abstract

“…These rapid changes in lifestyle are believed to have contributed to the dramatic increase in diabetes prevalence from 0.9 % in 1980 [2] to 11.6 % in 2010 [3•]. Together with the prevalence of gestational diabetes of 8.1 %–10.9 % [4, 5] and childhood obesity of 5.5 % [6], early-onset type 2 diabetes has emerged as a major public health challenge associated with premature morbidity and mortality [7]. This is compounded by an aging society with increasing frailty, which can be amplified by the comorbidities of diabetes in China [8].…”

Section: Introduction: Diabetes In Chinamentioning

confidence: 99%

Prevention and Care Programs Addressing the Growing Prevalence of Diabetes in China

2016

View full text Add to dashboard Cite

According to a 2010 national survey, 11 % of adults in China have diabetes, affecting 109.6 million individuals. The high prevalence of diabetes has been attributed to the aging of the population, the rapid adoption of energy-dense foods, and a reduction in physical activity. Collectively, these secular changes have created an obesogenic environment that can unmask diabetes in subjects with a genetic predisposition. The growing prevalence of maternal obesity, gestational diabetes, childhood obesity, and early-onset disease can lead to premature morbidity and mortality. Rising to meet these public health challenges, researchers in China have conducted randomized studies to demonstrate the benefits of lifestyle modification in preventing diabetes (the Da Qing Study), as well as that of team-based integrated care, using multiple strategies including peer support and information technology, in order to reduce hospitalizations, cardiovascular-renal complications, and premature deaths. With growing evidence supporting the benefits of these diabetes prevention and management programs, the next challenge is to use policies and systems to scale up the implementation of these programs through raising awareness, building capacity, and providing resources to reduce the human and socioeconomic burden of diabetes.

show abstract

Premature Mortality and Comorbidities in Young-onset Diabetes: A 7-Year Prospective Analysis

Cited by 119 publications

References 29 publications

Effect of Depression and Diabetes Mellitus on the Risk for Dementia

Effect of Depression and Diabetes Mellitus on the Risk for Dementia

Diabetes in Asia and the Pacific: Implications for the Global Epidemic

Prevention and Care Programs Addressing the Growing Prevalence of Diabetes in China

Contact Info

Product

Resources

About