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Temporal trends in treatment-requiring microvascular complications in young-onset diabetes: A nationwide
Hwa Young Kim1, Eunjeong Ji2, Jaehyun Kim1
1Department of Paediatrics, Seoul National University Bundang Hospital, Seongnam, the Republic of Korea; Department of Paediatrics, Seoul National University College of Medicine, Seoul, the Republic of Korea.
Aims:
Microvascular complications contribute to long-term morbidity, but data on young-onset diabetes in Korea are limited. We examined trends and risk factors for treatment-requiring microvascular complications in young-onset diabetes.
Methods:
Data from the Korean Health Insurance Review and Assessment Service (2008-2021) for individuals diagnosed with diabetes before age 30 years were analyzed. Treatment-requiring microvascular complications were defined using diagnostic codes with relevant prescriptions or procedures. Age-standardized incidence and prevalence were estimated using Poisson regression, and risk factors were assessed using time-dependent Cox models.
Results:
We included 6,202 and 77,815 individuals with type 1 and type 2 diabetes, respectively. In type 1 diabetes, microvascular complications incidence declined from 32.2 to 12.0 per 1,000 persons, while prevalence increased until 2012 and subsequently declined to 71.4 in 2021. In type 2 diabetes, both the incidence (from 31.4 to 12.4) and prevalence (from 72.6 to 43.1) declined steadily. In type 1 diabetes, young adulthood, female sex, and hypertension increased risk; in type 2 diabetes, young adulthood, male sex, low socioeconomic status, and greater comorbidity burden were key predictors.
Conclusions:
Treatment-requiring microvascular complications in young-onset diabetes declined in Korea, but persistent age- and socioeconomic-related disparities highlight the need for equitable prevention and management.
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