Initial Glycemic Control and Care Among Younger Adults Diagnosed With Type 2 Diabetes

OBJECTIVE: The prevalence of type 2 diabetes is increasing among adults under age 45. Onset of type 2 diabetes at a younger age increases an individual's risk for diabetes-related complications. Given the lasting benefits conferred by early glycemic control, we compared glycemic control and initial care between adults with younger onset (21-44 years) and mid-age onset (45-64 years) of type 2 diabetes. RESEARCH DESIGN AND METHODS: ≥6.5% ≥48 mmol/mol). We excluded anyone with evidence of prior type 2 diabetes, gestational diabetes mellitus, or type 1 diabetes. We used generalized linear mixed models, adjusting for demographic and clinical variables, to examine differences in glycemic control and care at 1 year. RESULTS: at diagnosis. Adults with younger onset had lower odds of in-person primary care contact (aOR 0.82 95% CI 0.76-0.89) than those with onset during mid-age, but they did not differ in telephone contact (1.05 0.99-1.10). Adults with younger onset had higher odds of starting metformin (aOR 1.20 95% CI 1.12-1.29) but lower odds of adhering to that medication (0.74 0.69-0.80). CONCLUSIONS: Adults with onset of type 2 diabetes at a younger age were less likely to achieve glycemic control at 1 year following diagnosis, suggesting the need for tailored care approaches to improve outcomes for this high-risk patient population.