Health Medical

Early onset of diabetes a factor in death, comorbidities


HQ Team

October3, 2022: According to a Health and Retirement Study survey, the age you get diabetes determines mortality and risk of comorbidities in older adults.

A population-based, biennial longitudinal health interview survey that interviewed 7,739 adults ages 50 and older found that diabetes diagnosis at 50 to 59 years was significantly associated with mortality (HR 1.49, 95% CI 1.29-1.71) compared with no diabetes diagnosis. 

The participants were also susceptible to associated risks for several comorbidities compared to the control group, including:

  • Incident heart disease: HR 1.66 (95% CI 1.40-1.96)
  • Stroke: HR 1.64 (95% CI 1.30-2.07)
  • Disability: HR 2.08 (95% CI 1.59-2.72)
  • Cognitive impairment: HR 1.30 (95% CI 1.05-1.61)

The onset of diabetes in adults one decade older — ages 60 to 69 — these associated risks were found to be significantly lower. This age group saw a 10% higher risk for death versus controls, as well as a 25% higher risk for incident heart disease, a 41% higher risk of stroke, and a 44% higher risk of disability, but no higher risk for cognitive impairment.

Furthermore, adults diagnosed with diabetes after 70 saw very few of these associated risks. This age group showed only an 8% higher risk for mortality and a 15% higher risk for heart disease.

“The mechanisms that link earlier diabetes diagnosis to worse outcomes are not completely understood,” the researchers of the survey said. “The longer duration of diabetes in individuals with earlier diagnosis has been reported in several previous studies. In contrast, in our study, the age-at-diagnosis association persisted when diabetes duration was fully adjusted by comparing incident outcomes starting from the age at diabetes diagnosis.”

One reason for the risks of earlier death and associated health problems in the younger age group could be because these people contracted “a more physiologically aggressive form of diabetes, with worse glycemic control, beta cell dysfunction, insulin insufficiency, and insulin resistance,” leading to worse outcomes, believe the researchers.

The study scholars used data from participants in the Health and Retirement Study from 1995 to 2018, including 1,866 adults diagnosed with diabetes in their 50s, 2,834 diagnosed in their 60s, and 3,039 diagnosed in their 70s.

Diabetes and other outcomes assessed were self-reported. Cognitive impairment was also measured. via a questionnaire

The percentage of women with diabetes was found to be more than men across all age ranges. Black and Hispanic men reported more diabetes incidents in younger adults of 50. However, white adults reported a higher diabetes diagnosis late in life. 

The survey was undertaken by Judy Zhong, PhD, of NYU Grossman School of Medicine in New York City, and colleagues and was published in the JAMA Network Open.

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