LAUSR

AIM To assess the relationship between type 2 diabetes mellitus (T2DM) onset age and vascular complications in China. METHODS A retrospective review of 3,568 patients with T2DM using a propensity score-matched (PSM) cohort analysis, was performed in two different age of onset groups (40 and 60 years old). These groups were then sub-divided into two groups, early onset diabetes (EOD40 and EOD60; the onset age before 40 and 60 years old respectively) and late onset diabetes (LOD40 and LOD60: the onset age after 40 and 60 years old, respectively). Macrovascular and microvascular complications were analyzed before and after PSM. RESULTS Patients categorized in the both age early-onset disease (EOD) groups had higher risk of developing macro- and microvascular complications before PSM. After PSM, no differences existed between the EOD and late-onset disease (LOD) groups in risk of macrovascular complications. Compared to the LOD group, the odds ratio of having a microvascular complication of diabetic retinopathy, chronic kidney disease, and diabetic peripheral neuropathy in the 40-year-old EOD group increased to 2.906, 1.967, and 1.672 (p < 0.05), respectively. The odds ratio of diabetic retinopathy and diabetic peripheral neuropathy in the 60-year-old EOD group was 1.763 and 1.675 (p < 0.05), respectively. CONCLUSION The earlier onset of T2DM, the higher risk of microvascular but not necessarily macrovascular complications. It is not too late to prevent diabetes at any age. Preemptive microvascular treatment or preventative measures in EOD patients who do not yet show symptoms, may be beneficial.