Young adults with diabetes have less favorable cardiometabolic risk profile versus those without, study finds

Compared to young adults without diabetes, those with diabetes were more likely to have obesity, elevated lipids, or hypertension and were less likely to report being physically active or consuming a healthy diet.

Young adults with diabetes have higher rates of cardiometabolic risk factors compared to those without, and between-group differences in obesity and lipid levels were much higher than in comparisons of older adults with and without diabetes, a study found.

Researchers obtained data from the National Health and Nutrition Examination Survey 2007-2016 to compare the cardiometabolic risk profiles of young (age <45 years) and older adults with and without diabetes. Cardiometabolic risk profiles included adiposity, blood pressure, serum lipids, healthy eating, physical activity, and exposure to tobacco smoke. Results were published online on June 20 by Diabetes Care.

Compared with those without diabetes, young adults with diabetes were more likely to have a high total-to-high-density lipoprotein cholesterol ratio, elevated blood pressure levels or hypertension, uncontrolled high cholesterol, chronic kidney disease, and self-reported history of cardiovascular disease. Young adults with diabetes were 14.0 percentage points (95% CI, 9.4 to 18.5) more likely to have elevated cholesterol levels and 4.2 percentage points (95% CI, 1.3 to 7.0) more likely to have elevated blood pressure compared with those without diabetes.

The percentage of young adults with diabetes who were obese, measured by body mass index or waist circumference-to-height ratio, was twice as high compared to young adults without diabetes. Young adults with diabetes were also less likely to report consuming a healthy diet or engaging in leisure-time physical activity compared with those without diabetes (7.0 percentage points [95% CI, 2.3 to 11.4] and 12.1 percentage points [95% CI, 7.0 to 17.2], respectively).

Differences in high cholesterol and adiposity by diabetes status were greater among young adults compared with older adults after adjustment for demographics and health insurance status. In comparisons between young adults with diabetes and those without diabetes, elevated lipids were 9.6 percentage points higher (95% CI, 4.6 to 14.5) and obesity was 37.3 percentage points higher (95% CI, 31.8 to 42.7) than in comparisons between older adults with and without diabetes.

The authors pointed out that they did not distinguish between type 1 and type 2 diabetes and that diabetes was determined by self-report or by HbA1c levels, among other limitations. However, they noted that the number of young adults with diabetes in the U.S. is expected to more than double by 2030, exceeding 5 million. “A better understanding of the modifiable differences between the young and older populations with diabetes can illuminate how best to improve the cardiometabolic risk profile of this younger population, which can be an important contribution to reducing future diabetes-related morbidity and mortality rates,” they wrote.