Review: Early-onset type 2 diabetes mellitus: a condition with elevated cardiovascular risk?

Abstract

The age of onset of type 2 diabetes mellitus is falling and this condition has become increasingly common among those aged under 30 years including children and adolescents. Early-onset type 2 diabetes has been reported in various countries from different ethnic and cultural backgrounds reflecting the effects of sedentary lifestyle as part of globalisation and industrialisation affecting all societies. The pathophysiological features of early-onset type 2 diabetes is similar to the later-onset cohort characterised by β-cell failure and obesity-induced insulin resistance but the decline in β-cell function appears to be more rapid. Early-onset type 2 diabetes may be a more aggressive disease phenotype to develop cardiovascular complications than later-onset cohort, reflected by more adverse cardiovascular risk profile and higher relative risk for myocardial infarction. Given the paucity of clinical trial evidence in this population, clinical judgement is required to initiate treatments to prevent cardiovascular complications guided by assessment of global cardiovascular risk. Future research strategies should include exploration of cardiovascular risk factors. its natural history, development of complications and outcome studies pertaining to the treatment of cardiovascular risk factors.