Microvascular complications increase with diabetes duration but not age

From Clinical Endocrinology News, 3 January 2014:

MELBOURNE – A diagnosis of type 2 diabetes before age 50 was associated with an increased risk of microvascular complications, based on a secondary analysis of data from the international ADVANCE trial.

In ADVANCE, the risk of microvascular complications, such as eye and kidney disease, increased with disease duration but not with patient age. The risk of macrovascular complications, such as myocardial infarction, stroke, and cardiovascular events, as well as all-cause mortality, increased with both patient age and disease duration, Dr. John Chalmers, principal investigator for ADVANCE, said at the World Diabetes Congress.

“The findings tell you that if you get [type 2 diabetes] early, you’re in for a rougher time. If you’re younger at the time of diagnosis, then you may have a slightly more progressive, aggressive, resistant-to-treatment form of type 2 diabetes. It’s important to be aware of that, to control the glucose and to keep looking at the kidneys and eyes,” said Dr. Chalmers, senior director of the George Institute, Sydney, and emeritus professor of medicine at the University of Sydney.

ADVANCE is a randomized trial across 20 countries of blood pressure lowering and intensive versus standard glucose control in 11,140 adults with type 2 diabetes who were followed up for 5 years. Mean age at study entry was 66 years, and average diabetes duration was 7.9 years. However when patients were stratified in 5-year increments of disease duration, researchers observed that the average age for each increment was roughly the same, around 66 years. Read more.

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