U.S. Department of Health and Human Services

Youth with type 2 diabetes develop complications more often than peers with type 1 diabetes

Researchers have found that teens and young adults with type 2 diabetes develop common diabetic complications more often than their peers with type 1 diabetes in the years shortly after diagnosis. These findings are from the SEARCH for Diabetes in Youth study, which is the largest study of its kind in the United States. SEARCH includes a geographically and racially/ethnically diverse group of children and adolescents who were under 20 years of age when they were diagnosed with type 1 or type 2 diabetes.

As both types of diabetes are on the rise in young people, SEARCH researchers examined how quickly and how often those diagnosed in youth with type 1 or type 2 diabetes go on to develop the kidney, nerve, and eye diseases that are common diabetic complications, as well as several risk factors for heart disease. Included in the study were 1,746 youth diagnosed with type 1 diabetes and 272 diagnosed with type 2 diabetes between 2002 and 2015. All had participated in follow-up examinations that measured risk factors for complications, and had diabetes, on average, for just under 8 years when their diabetes complications were assessed.

From this assessment data, and taking into account the different ages at which the youth were diagnosed, the researchers estimated the chances of youth with diabetes developing complications over time. They estimated that by about age 21, approximately 32 percent of participants with type 1 diabetes and 72 percent of participants with type 2 diabetes would have at least one complication from diabetes or would be at high risk for a complication. For those with type 2 diabetes, this included nearly 20 percent with a sign of kidney disease, 18 percent with nerve disease, and 9 percent with eye disease. For those with type 1 diabetes, this included about 6 percent with a sign of kidney disease, 9 percent with nerve disease, and about 6 percent with eye disease. Measures for two risk factors for heart disease (hypertension and arterial stiffness) were greater for youth with type 2 diabetes than those with type 1 diabetes, but were close to equal between the two groups for a third risk factor (cardiovascular autonomic neuropathy). The researchers looked at factors including blood glucose (sugar) control, body mass index (a measure of weight relative to height), and blood pressure, but none of these factors explained the differences they observed, suggesting that more research into how and why diabetic complications occur in young people is needed.

These findings also suggest that early monitoring of youth with both types of diabetes could result in earlier diagnosis and treatment of complications, which could ultimately contribute to better health over the lifespan.

Dabelea D, Stafford JM, Mayer-Davis EJ, D'Agostino R, Dolan L, Imperatore G, Linder B, Lawrence JM, Marcovina SM, Mottl AK, Black MH, Pop-Busui R, Saydah S, Hamman RF, and Pihoker C; for the SEARCH for Diabetes in Youth Research Group.  Association of type 1 diabetes vs type 2 diabetes diagnosed during childhood and adolescence with complications during teenage years and young adulthood.  JAMA 317: 825-835, doi:10.1001/jama.2017.0686, 2017.