Complications and cardiovascular risk factors in South Asians and Europeans with early-onset type 2 diabetes.
BACKGROUND
Type 2 diabetes is a major cardiovascular risk factor, and early-onset (<40 years) type 2 diabetes is becoming more common.


AIM
To determine the prevalence of complications, and cardiovascular risk factors at diagnosis, in early-onset type 2 diabetes, and to compare these between South Asians and Europeans.


DESIGN
Prospective study of newly-diagnosed type 2 diabetes patients aged <40 years, attending hospital and primary care clinics 1999-2001.


METHODS
Patients were assessed for signs of macrovascular disease, retinopathy, neuropathy and nephropathy. Cardiovascular risk factors were also determined.


RESULTS
Overall, 292 patients were enrolled (165 South Asians). Macrovascular disease was more prevalent in South Asians (15.7% vs. 9.4%, p<0.001), as was microvascular disease (27.3% vs. 16.5%, p<0.001), including retinopathy (17.5% vs. 7.9%, p<0.001), and nephropathy (18.1% vs. 7.8%, p<0.001). South Asians had trends towards greater waist:hip ratio (0.95 vs. 0.90), and higher blood pressure (127/80 vs. 123/76 mmHg). HDL cholesterol was lower (1.0 vs. 1.3 mmol/l, p<0.001) and fasting triglycerides higher (1.9 vs. 1.5 mmol/l, p<0.001) in South Asians. Absolute CHD risk was significantly higher in South Asians (16.9% vs. 13.7%, p<0.001).


DISCUSSION
Complications were common at diagnosis, with a quarter of all patients having evidence of at least one diabetic complication. South Asians had a higher prevalence of established macrovascular and microvascular disease, compared to Europeans, and a higher risk of CHD, predominantly because of lower HDL cholesterol and higher blood pressure.