INTRODUCTION: Diabetes will remain a threat to global health. The global burden of type 2 diabetes mellitus is significant and rising, with most of the increase occurring in the last two decades. While most of the rise in the prevalence of Type 2 diabetes mellitus occurs in the middle-aged and the elderly, it is becoming more common in younger patients. No longer just a disorder of mature age, there is now a well-recognized trend toward younger people presenting with the disease.
METHODS: This was a cross sectional study of medical records of adult patients at the University of Santo Tomas Hospital who met the inclusion criteria from January 2015 to December 2017. The subjects were divided into early onset (<40 years of age) and the late onset (≥40 years of age) group. Mean, standard deviation, counts and percentages were used to summarize data. The mean values of continuous variables between the two groups were analyzed using the independent sample t-test while categorical variables were analyzed using Chi square test. Logistic regression analysis was used to determine the association of age of onset and duration of diabetes to its complications.
RESULTS: The mean age for the early onset group was 34 years old, while that of the late onset group was 51 years old. No gender predilection was observed in both groups. The subjects of the early onset group were mostly obese as compared to the late onset group who were mostly overweight. Both groups were mostly smokers, and had a positive family history with an almost equal proportion of females having a history of gestational diabetes. The early onset group had higher hba1c and worse lipid profiles upon diagnosis. The most common comorbid illnesses observed in both groups include hypertension, dyslipidemia, fatty liver and metabolic syndrome. In terms of macrovascular complications, the frequency of myocardial infarction was higher in the late onset group. For the microvascular complications, the proportion of retinopathy was higher in the early onset group while the frequency of neuropathy was higher in the late onset group. Lastly, for both groups, the duration of diabetes was associated with microvascular complications such that for every year increase in the duration of diabetes, patients were more likely to develop retinopathy and neuropathy.
CONCLUSION: The mean age of Filipinos with early onset diabetes were at least 5 years younger as compared to Caucasians. Moreover, they were more obese, had worse lipid profiles and higher Hba1C levels. Among the macrovascular and microvascular complications, a higher proportion of the late onset group had peripheral neuropathy and had history of myocardial infarction while retinopathy was more prevalent in the early onset group. Lastly, for every year increase in the duration of diabetes, patients were more likely to develop retinopathy and neuropathy.