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Updated: May 16, 2026

A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
Clinical characteristics, disease course, and clinical subgroups of young adults with type 2 diabetes
Anu Sharma1,2, Jose M Lazaro-Guevara3,4,5, Devorah Stucki5
1Division of Endocrinology, Metabolism and Diabetes, University of Utah School of Medicine, Salt Lake City, UT 84108, USA.
Context:
Type 2 diabetes (T2D) in young adults is an emerging entity distinct from that in older adults.
Objective:
To identify unique clinical subgroups among young adults using clinical variables.
Methods:
Utilizing the Utah Diabetes Database, a retrospective cohort study was performed with data from 56 327 individuals with T2D as defined by International Classification of Diseases codes and analyzed by predefined groups: young adults (18-44 years) and older adults (≥45 years). De novo k-means clustering was performed.
Results:
Young adults with T2D (yT2D) were more likely to be female (51%), self-identify as racial/ethnic minorities (24%), and have obesity (68%). Compared to older adults, yT2D at baseline had worse glycemic control (hemoglobin A1c [HbA1c] 7.8 ± 2.5% vs 7.3 ± 2.0%, P < .001), higher body mass index (BMI; 34 ± 9 vs 32 ± 7 kg/m2, P < .001) and higher estimated glomerular filtration rate (eGFR; 100 ± 25 vs 73 ± 23 mL/min/1.73 m2, P < .001). Over time, the increase in HbA1c and BMI was greater in yT2D compared with older adults (P < .01) with no difference in eGFR change. Three unique clusters were determined: cluster 1 had higher BMI and lower HbA1c; cluster 2 had a higher HbA1c and was more likely to need insulin; and cluster 3 had a lower eGFR and more diabetes-related comorbidities.
Conclusion:
yT2D have worse glycemic control, greater obesity, and similar renal decline compared with older adults with T2D. A high-risk subgroup of yT2D presents with a significantly lower eGFR. More research is needed to determine whether targeted therapy to high-risk groups will reduce diabetes-related complications.
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