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Earlier onset of type 2 DM compared to late-onset type 2 DM increases the risk of developing microvascular complications, but may not increase risk of macrovascular complications. Patients with EOD may benefit from preventive and therapeutic measures before the onset of symptoms of vascular complications.

Microvascular and macrovascular complications of type 2 diabetes mellitus (DM) have adverse outcomes. Atherosclerosis is a macrovascular complication that is evident in type 2 DM patients and significantly impairs life expectancy by increasing the risk of developing stroke, myocardial infarction, diabetic nephropathy, and diabetic retinopathy. Early-onset diabetes (EOD) and late-onset diabetes (LOD) may differ regarding vascular complications and clinical features of the disease.
This retrospective review, published in the Journal of Diabetes Investigation, assessed the relationship between type 2 DM onset age and vascular complications. A total of 3568 type 2 DM patients were included in the study. The patients were divided into two groups based on the age of onset (40 years and 60 years) – EOD40 and LOD60. The study employed a propensity score matched (PSM) cohort analysis, and the microvascular and macrovascular complications of type 2 DM were analyzed before and after the analysis.
Results revealed that the patients in the EOD40 group were at a greater risk for developing microvascular and macrovascular complications of type 2 DM before the PSM cohort analysis. After conducting the PSM cohort analysis, no differences were observed between the EOD and LOD groups in terms of risk for macrovascular complications. The odds ratio of the development of microvascular complications of type 2 DM was increased in the patients in the EOD40 group compared to those in the LOD60 group.
In summary, the risk of microvascular complications rises with the early onset of type 2 DM. However, this is not necessarily applicable to macrovascular complications. Preventive measures and preemptive treatment can be administered in patients with early-onset type 2 DM who are not symptomatic for vascular complications.

Huang, L., Wu, P., Zhang, Y., Lin, Y., Shen, X., Zhao, F., & Yan, S. (2022). Relationship between onset age of type 2 diabetes mellitus and vascular complications based on propensity score matching analysis. J Diabetes Investig, 13(6), 1062-1072. https://doi.org/10.1111/jdi.13763

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