Objective

The aim of this study was to compare the differences in incident population, comorbidities, and glucose-lowering drug prescriptions between newly diagnosed patients with early-onset type 2 diabetes mellitus (T2DM) and those with late-onset T2DM to provide real-world evidence for clinical practice.

Methods

This study was based on the Shanghai Hospital Link Database (SHLD). Anonymized electronic medical record (EHR) data from 2013 to 2021 were included in this study. Newly diagnosed patients with T2DM were defined as those without related diagnostic records or glucose-lowering medicine prescriptions in the past 3 years. Early-onset T2DM was defined as patients who were aged 18–40 years old at the first visit for T2DM to represent those who were born after the 1980s. And late-onset T2DM was defined as those aged 65–80 years old to represent those who were born in a relatively undeveloped period. Descriptive statistical analyses were performed to describe their incidence number, glucose-lowering drug prescriptions, and comorbidities at the first visit to the hospital between two T2DM groups.

Results

There were a total of 35,457 newly diagnosed patients with early-onset T2DM and 149,108 newly diagnosed patients with late-onset T2DM included in this study. Patients with late-onset T2DM constituted the majority and their number increased by 2.5% on average by years, while the number of patients with early-onset T2DM remained stable each year. Compared with late-onset T2DM patients, more early-onset T2DM patients had dyslipidemia at the first visit to hospitals (9.5% vs 7.7%, P < 0.01) despite their significant age differences. Patients with early-onset T2DM were more likely to use metformin (74.8% vs 46.5, P < 0.01), dipeptidyl peptidase-4 inhibitors (DDP-4i) (16.7% vs 11.2%, P < 0.01), thiazolidinediones (TZD) (14.9% vs 8.4%, P < 0.01), sodium glucose cotransporter 2 inhibitors (SGLT2-i) (0.8% vs 0.3%, P < 0.01), and glucagon-like peptide 1 receptor agonists (GLP-1 RA) (3.7% vs 0.5%, P < 0.01) at their first visit to the hospital.

Conclusions

Different characteristics were observed between patients with early-onset T2DM and those with late-onset T2DM. Compared with patients with late-onset T2DM, those with early-onset T2DM were more prone to dyslipidemia and had novel organ-protective drugs prescribed.

中文翻译：

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新诊断的早发型和晚发型 T2DM 临床结果的比较：来自上海医院链接数据库的真实世界研究

客观的

本研究的目的是比较新诊断的早发性 2 型糖尿病 (T2DM) 和晚发性 T2DM 患者在发病人群、合并症和降糖药物处方方面的差异，以提供真实世界的证据用于临床实践。

方法

本研究基于上海医院链接数据库（SHLD）。本研究纳入了 2013 年至 2021 年的匿名电子病历 (EHR) 数据。新诊断的T2DM患者定义为近3年内无相关诊断记录或降糖药物处方的患者。早发型T2DM被定义为首次就诊时年龄在18-40岁的患者，代表20世纪80年代以后出生的患者。晚发型T2DM被定义为65-80岁的人群，代表出生在相对不发达时期的人群。进行描述性统计分析来描述两个 T2DM 组之间的发病率、降糖药物处方以及首次就诊时的合并症。

结果

本研究共纳入35,457例新诊断的早发T2DM患者和149,108例新诊断的晚发T2DM患者。晚发T2DM患者占大多数，其人数平均逐年增加2.5%，而早发T2DM患者人数每年保持稳定。与晚发T2DM患者相比，早发T2DM患者首次就诊时出现血脂异常的比例更高（9.5% vs 7.7%，P < 0.01），尽管其年龄差异显着。早发性 T2DM 患者更倾向于使用二甲双胍（74.8% vs 46.5，P < 0.01）、二肽基肽酶 4 抑制剂（DDP-4i）（16.7% vs 11.2%，P < 0.01）、噻唑烷二酮类药物（TZD）（ 14.9% vs 8.4%, P < 0.01)、钠葡萄糖协同转运蛋白 2 抑制剂 (SGLT2-i) (0.8% vs 0.3%, P < 0.01) 和胰高血糖素样肽 1 受体激动剂 (GLP-1 RA) (3.7%) vs 0.5%，P < 0.01）在他们第一次去医院时。

结论

早发性 T2DM 患者和晚发性 T2DM 患者之间观察到不同的特征。与晚发性T2DM患者相比，早发性T2DM患者更容易出现血脂异常，并且需要服用新型器官保护药物。