Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

It is increasingly recognised that type 2 diabetes (T2D) with onset in young adulthood is an aggressive condition.  However, reliable data on long term complication outcomes in comparison to later onset T2D are lacking.  A cross sectional study of T2D patients attending the RPA Diabetes Centre (1990-2016) was undertaken.  Data relating to 4,457 clinical encounters were abstracted from the Diabetes Centre Database and outcomes by age of T2D onset analysed.   To account for increasing risk of complications by T2D duration, data were stratified into duration bands: 10-15, 15-20 and 20-25 years.  Binary logistic regression analysis was performed to compare microvascular complication rates (retinopathy, microalbuminuria and peripheral neuropathy) in age of diagnosis bands (15-29, 30-39, 40-49, 50-59 and 60-69 years).  Adjusted odds ratios after accounting for current age, gender, smoking, BMI, updated HbA1c, systolic blood pressure and cholesterol are presented.  The odds of any detectable retinopathy after 10-15 years of T2D were greatest in those with T2D onset 15-30 years (OR 4.7, p=0.005).  Similar results were seen 15-20 and 20-25 year duration bands, a pattern not observed in models of albuminuria or peripheral neuropathy.  Early onset T2D appears to be a particularly aggressive disease with respect to the microvascular complication of retinopathy, even accounting for duration of disease and traditional risk factors, including HbA1c exposure.  Whether factors such as greater growth hormone bioactivity in youth may account for this relationship remains to be determined.