1. Long-Term Complications and Mortality in Young-Onset Diabetes Type 2 diabetes is more hazardous and lethal than type 1 diabetes Featured Article: Maria I. Constantino, BInfoTech, Lynda Molyneaux, R.N., Frankziska Limacher- Gisler, MClinTPrac, Abdulghani Al-Saeed, M.D., Connie Luo, R.N., Ted Wu, M.D., P.H.D., Stephen M. Twigg, M.D., P.H.D., Dennis K. Yue, M.D., P.H.D., Jencia Wong, M.D., P.H.D. Diabetes Care Volume 36: 3863-3869 December, 2013

2. STUDY OBJECTIVE To evaluate long-term clinical outcomes and survival in young-onset type 2 diabetes (T2DM) compared with type 1 diabetes (T1DM) with a similar age of onset Constantino M. I. et al. Diabetes Care 2013;36:3863-3869

3. STUDY DESIGN AND METHODS Records from the Royal Prince Alfred Hospital Diabetes Clinical Database were matched with the Australian National Death Index Mortality outcomes for all subjects until June 2011 were established Clinical and mortality outcomes in 354 patients with T2DM, age of onset between 15 and 30 years (T2DM15–30), were compared with T1DM Primary comparison was with 470 patients with T1DM with a similar age of onset (T1DM15–30) to minimize the confounding effect of age on outcome Constantino M. I. et al. Diabetes Care 2013;36:3863-3869

4. RESULTS Median observation period was 21.4 (interquartile range 14– 30.7) and 23.4 (15.7–32.4) years for the T2DM and T1DM cohorts, respectively 71 of 824 patients (8.6%) died A significant mortality excess was noted in T2DM15–30 with an increased hazard for death Constantino M. I. et al. Diabetes Care 2013;36:3863-3869

5. RESULTS Death for T2DM15–30 occurred after a significantly shorter disease duration and at a relatively young age There were more cardiovascular deaths in T2DM15–30 Albuminuria and less favorable cardiovascular risk factors were greater in T2DM15–30 Neuropathy scores and macrovascular complications were also increased in T2DM15–30 Constantino M. I. et al. Diabetes Care 2013;36:3863-3869

8. CONCLUSIONS Compared with T1DM, young-onset T2DM is the more lethal phenotype of diabetes and is associated with: Greater mortality More diabetes complications Unfavorable cardiovascular disease risk factors Constantino M. I. et al. Diabetes Care 2013;36:3863-3869