Age at type 2 diabetes diagnosis, mortality, and health loss in South Asians

We examined associations between age at type 2 diabetes (T2D) diagnosis and long-term mortalityand lifetime health loss.

We analyzed data from the population-based CARRS cohort. T2D was defined by self-report, glucose-lowering medication use, or glycemic thresholds and categorized by age at diagnosis (20-29, 30-39, 40-59, or ≥60 years). Hazard ratios (HRs) were estimated using time-dependent Cox models with participants without T2D as reference group. Model-based projections estimated years of life lost (YLL), years lived with disability (YLD), disability-adjusted life years (DALYs), and excess life-years lost (LYL).

Among 21,574 participants (mean age 43.3 years), 6,251 had diabetes. Over a median follow-up of 8.7 years, 2,163 deaths occurred. Younger age at T2D diagnosis was associated with higher risks of mortality and cardiovascular events. Adjusted HRs for all-cause mortality were 2.98 (95% CI 1.60-5.54) for T2D diagnosis at 20-29 years, 2.28 (1.74-2.98) at 30-39 years, 1.73 (1.47-2.04) at 40-59 years, and 1.61 (1.30-1.99) at ≥60 years. Projected lifetime DALYs were greatest with younger diagnosis, ranging from 24.5 years for diagnosis at 20-29 years to 5.5 years at > 60 years, with similar gradients for excess LYL.This pattern was also observed for CVD eventsacross age groups.

T2D diagnosed at a younger age was associated with higher mortalityand greater LYL in South Asians.