Early and later onset type 2 diabetes in uninsured patients: clinical and behavioral differences

J Health Care Poor Underserved. 2008 Nov;19(4):1119-35. doi: 10.1353/hpu.0.0072.


Objective: The national burden of type 2 diabetes mellitus (T2DM) is increasing rapidly. This study investigated a) clinical differences between early onset and later onset T2DM; and b) if specific risk factors were associated with age at diagnosis or clinical outcomes among uninsured adults in a large urban setting.

Methods: We compared 417 adults diagnosed under age 30 with 968 adults diagnosed ages 50-58 on clinical and social measures using standard parametric tests.

Results: Early onset patients had higher hemoglobin A1c, were more likely to smoke and to be depressed, and had more emergency department visits. Insulin monotherapy was more common in early onset patients (32% vs. 11%). Complications were already present in 11% of early onset patients and 29% of later onset patients within one year of diagnosis.

Conclusion: Early onset patients had more acute beta-cell failure and coped less well with their diabetes. It is crucial to expand specialized diabetes resources for young, medically indigent patients.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Comorbidity
  • Diabetes Complications / epidemiology
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / psychology*
  • Drug Utilization
  • Female
  • Glycated Hemoglobin / analysis
  • Health Behavior*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Male
  • Medically Uninsured / statistics & numerical data*
  • Middle Aged
  • Risk Factors
  • Smoking
  • Socioeconomic Factors
  • Time Factors
  • Young Adult


  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin