Aims/hypothesis: We tested the hypothesis that age younger than 65 years at type 2 diabetes diagnosis is associated with worse subsequent glycaemic control.
Methods: A cross-sectional analysis of data from participants in the 2005-2010 National Health and Nutrition Examination Survey was performed. For adults with self-reported diabetes, we dichotomised age at diabetes diagnosis as younger (<65 years) vs older (≥ 65 years). The primary outcome of interest was HbA1c >9.0% (75 mmol/mol). Secondary outcomes were HbA1c >8.0% (64 mmol/mol) and >7.0% (53 mmol/mol). We used multivariable logistic regression for analysis.
Results: Among 1,438 adults with diabetes, a higher proportion of those <65 years at diagnosis compared with those ≥ 65 at diagnosis had an HbA1c >9.0% (14.4% vs 2.5%, p < 0.001). After adjustment for sex, race/ethnicity, education, income, insurance, usual source of care, hyperglycaemia medication, duration of diabetes, family history, BMI and waist circumference, age <65 years at diagnosis remained significantly associated with greater odds of HbA1c >9.0% (OR 3.22, 95% CI 1.54, 6.72), HbA1c >8.0% (OR 2.72, 95% CI 1.43, 5.16) and HbA1c >7.0% (OR 1.92, 95% CI 1.18, 3.11). The younger group reported fewer comorbidities, but were less likely to report good health (OR 0.54, 95% CI 0.36, 0.83).
Conclusions/interpretation: Younger age at type 2 diabetes diagnosis is significantly associated with worse subsequent glycaemic control. Because patients who are younger at diagnosis have fewer competing comorbidities and complications, safe, aggressive, individualised treatment could benefit this higher-risk group.