Younger, leaner patients may have undiagnosed type 2 diabetes, study finds
An analysis of 56 national health surveys throughout the world found that a substantial proportion of patients with a fasting plasma glucose level of 126 mg/dL (7.0 mmol/L) or greater may be younger than age 35 years and/or be in the underweight or normal weight category.
Type 2 diabetes frequently occurs in younger patients and those of normal weight, a recent study found.
Researchers analyzed adults ages 25 through 69 years who participated in international WHO STEPS surveys, which included data on age, sex, weight, height, and blood biomarkers, including fasting plasma glucose. They defined patients with new type 2 diabetes using a fasting plasma glucose level of 126 mg/dL or greater (≥7.0 mmol/L) during the survey. For those with a new type 2 diabetes diagnosis, the researchers summarized the mean age and the proportion of each five-year age group, as well as the mean body mass index (BMI) and the proportion of mutually exclusive BMI categories. Results were published July 8 by Diabetic Medicine.
The study included 56 national health surveys conducted between 2004 and 2019, most of which were from the Western Pacific and Africa. Other regions included the Eastern Mediterranean, Europe, Southeast Asia, and the Americas. Overall, across all countries, the researchers identified 8,695 patients with undiagnosed type 2 diabetes. The mean age at diabetes identification was 45.1 years (95% CI, 44.0 years to 46.1 years) in men and 45.0 years (95% CI, 43.8 years to 46.1 years) in women. In men, 10.4% (95% CI, 6.7% to 14.0%) of patients with new type 2 diabetes were ages 25 to 29 years and 8.5% (95% CI, 6.0% to 11.1%) were ages 30 to 34 years. In women, 8.6% (95% CI, 6.2% to 11.0%) were ages 25 to 29 years and 12.6% (95% CI, 9.9% to 15.2%) were ages 30 to 34 years. The mean BMI at diabetes identification was 25.2 kg/m2 (95% CI, 24.8 kg/m2 to 25.6 kg/m2) in men and 26.9 kg/m2 (95% CI, 26.4 kg/m2 to 27.4 kg/m2) in women. Overall, 48.5% of men and 37.3% of women with new type 2 diabetes were in the normal BMI category (18.5 kg/m2 to 24.9 kg/m2).
Limitations include those inherent to large health surveys, as well as the fact that type 2 diabetes diagnosis was based on only fasting plasma glucose, the study authors noted. They added that the sample size was small in some countries.
“Our findings may support the revision of T2DM [type 2 diabetes mellitus] screening guidelines to acknowledge the sex- and country-specific need to screen for T2DM in young and lean adults, pending further verification of our findings and cost-effectiveness analyses,” the authors wrote.