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. 2020 Jan 10;21(2):158–172. doi: 10.1111/pedi.12953

Table 3.

Time from T2D diagnosis to a complication

Trial name/reference Study type Country, number of sites T2D diagnosis criteria used Number of participants Age range Age at diagnosis Time to complication Type of complication
19 Cross sectional United States, 1 study site—Children's Hospital and Research Center, Oakland T2D diagnosed based on random BG levels, HbA1c, OGTT and the absence of autoantibodies 15 with T2D; 32 with T1D; 26 CG Mean: 16.0 y T2D; 15.6 y T1D; 17.6 y CG NR At a duration of 2.1 y, 40% had impaired retinal time delay compared with 28% at a duration of 5.7 y in the T1D group and 8% in the CG
20 Chart review between 1986 and 2011 Australia, 1 site—Royal Prince Alfred Hospital Diabetes Clinical Database Not specified 354 with T2D; 470 with T1D 15‐30 y T2D, 25.6 ± 3.7 y; T1D, 22.0 ± 4.3 y

Mean diabetes duration of 11.6 y for T2D group and 14.7 y for T1D

Death occurred after 26.9 y of disease for T2D, and 36.5 y for T1D
For T2D vs T1D:
  • There were more deaths (11.0% vs 6.8%)
  • There were more CV deaths (50.0% vs 30.3%)
  • Macrovascular complications (14.4% vs 5.7%) were more common
  • Neuropathy VPT Z scores were increased (2.3 vs 1.8)
SEARCH‐Case Control study 21 Randomized United States, multicenter (Colorado, South Carolina) Physician diagnosis 106 with T2D; 189 in the CG Range: 10‐22 y; mean for T2D group = 15.7 y (4.4 SD); control = 14.3 y (4.6 SD) Mean (interquartile range) in patients with T2D, 13.7 (4.0) y; in control patients, 14.3 (4.6) y 1.5 y Higher prevalence in many CV risk factors when compared with CG. Average number of CVD risk factors in T2D group was 2.9 compared with 1.0 in the CG
SEARCH study 22 Observational United States, multicenter Physician diagnosed 43 with T2D; 222 with T1D <20 y NR Average of 7.2 y for T2D and 6.8 y in T1D 42% of patients with T2D had diabetic retinopathy compared with 17% of patients with T1D
SEARCH 23 Observational, 2002‐2015 United States, multicenter

Physician diagnosis followed by disease type classification based on 1 or more positive diabetes autoantibody results and

estimated insulin sensitivity score

 2018 in total; 272 with T2D; 1746 with T1D

<20 y in both groups

Mean age = 14.2 y (2.6 SD) in T2D group; 10.0 y (3.9 SD) in T1D group

 T2D, 14.2 (2.6) y; T1D, 10.0 (3.9) y At outcome visit, the mean diabetes duration was 7.9 y for both groups (1.9 SD for T2D and 2.0 SD for T1D)

  • Retinopathy in 9.1% of patients with T2D compared with 5.6% of patients with T1D

  • Diabetic kidney disease was higher in the T2D group compared with T1D (19.9% vs 5.8%)

  • Peripheral neuropathy was higher in T2D group (17.7% vs 8.5% in T1D group)

  • Hypertension was higher in T2D compared with T1D (21.6% vs 10.1%)
TODAY study 24 Randomized United States, multicenter ADA criteria 455 10‐17 y at randomization NR (diabetes duration was ≤2 y) Median of 4.5 y Cardiac end organ injury: 16.2% of patients had abnormalities in LV structure
TODAY study; the TODAY Study Group, 2013 25 Randomized, cross sectional United States, multicenter ADA criteria 699 10‐17 y at randomization NR

After an average of 3.9 y:

hypertension increased from 11.6% of patients to 33.8%;

microalbuminuria increased from 6.3% to 16.6%
26 Prospective, all incidence of T2D and T1D between January 1986 and 2007 Canada, multicenter Canadian Diabetes Association criteria 342 with T2D; 1011 with T1D; 1710 in CG Range: 1‐18 y; mean T2D group = 13.5 y (2.2 SD); mean T1D group = 8.9 y (4.3 SD); mean age of CG = NR NR Mean 1.6 y from diagnosis in the T2D group and 6.3 y in the T1D group

  • 26.9% of patients with T2D had persistent microalbuminuria compared with 12.7% in T1D

  • 4.7% of patients in the T2D group had persistent macroalbuminuria compared with 1.6% in T1D
27 Comparative clinic‐based study between 1996 and 2005 Australia, 1 study site—Children's Hospital at Westmead

Australasian Pediatric Endocrine

Group diabetes register criteria

 68 with T2D; 1433 with T1D Patients with T2D, median (interquartile range) 15.3 (13.6‐16.4) y; patients with T2D, median (interquartile range), 15.7 (13.9‐17.0) y;) Patients with T2D, median, 13.2 y; patients with T1D, median, 8.1 y 1.3 y (vs 6.8 y in T1D)

  • Retinopathy was more common in patients with T1D compared with T2D (20% vs 4%)

  • Microalbuminuria was more common in patients with T2D (28% vs 6% of T1D)

  • Hypertension was also more common with T2D (36% vs 16% in T1D group)
28 Longitudinal, from 1965 to 2002 United States (Pima Indian population) WHO criteria 178 youth onset; 1359 young adults; 971 older adults <20 y (youth onset); 20‐39 y (young adults); 40‐59 y (older adults) <20 y (youth onset); 20‐39 y (young adults); 40‐59 y (older adults) Measured in brackets of <5, 5‐10, 10‐15, 15‐20, 20‐25, and >25 y of diabetes duration

  • Rates of nephropathy were the same across age groups and increased with diabetes duration

  • Retinopathy was lower in youth‐onset T2D but increased with disease duration
29 Retrospective, electronic chart review from January 2001 to August 2012 United States, 1 study site—Department of Pediatric Endocrinology at the Children's Hospital of Birmingham, Alabama The ICD‐9‐CM diagnosis codes of 250.00 and 250.02 86 Mean: 13.8 y (2.4 SD) Mean (±SD) age at follow‐up 1, 14.2 (±2.4); follow‐up 2, 14.9 (±2.4) Mean (±SD), 13.8 (±2.4) y Measured after 1 y

  • CV risk factors did not improve despite insulin treatment from diagnosis

  • HbA1c levels were significantly higher in the group treated with insulin at diagnosis
30 a NR in the abstract Japan NR in the abstract 36 NR in the abstract NR in the abstract Retinopathy, which was only found in female patients (the 11 boys included in the study did not develop retinopathy). Dependent on HbA1c levels: <8.0% = 0% at 5 and 10 y, 5% at 15 y; >8.0% = 44% at 5 y, 56% at 10 and 15 y
31 Longitudinal between 1965 and 2002 United States, Pima Indian population WHO criteria 96 youth onset; 1760 older onset

<20 y in youth onset (median: 16.8 y);

25‐55 y in older onset (median: 36.9 y)

 NR Follow‐up defined as an event or December 2002 (up to 30 y for some individuals) End‐stage renal disease: 16% in youth‐onset group compared with 8% in older‐onset group
32 Retrospective medical record review Peru, single site NR 20 with T2D and 54 with T1D

<18 y

Mean T2D group = 12.6 y and mean T1D group = 7.7 y

 NR

Mean follow‐up time 3.7 y for T2D group and 5.7 y for T1D group.

Disease duration for the microalbuminuria data is 2.3 y for the T2D group and 4.7 y for the T1D group

  • Hypertension found in 34.5% of patients with T2D and 27.6% of patients with T1D

  • Microalbuminuria found in 42.9% of patients with T2D and 16.3% of patients with T1D
33 Markov‐like computer model United States Model, not actual data 817 relevant studies were identified to build the model 15‐24 y at diagnosis 15‐24 y LE of patients with T2D is 43 y from adolescence compared with nondiabetic peers with LE 58.6 y. Predicted 5% patients would have end‐stage renal disease after 25 y of disease Death and end‐stage renal disease
34 Logistic regression analysis United States, clinical Research Center at Cincinnati Children's Hospital ADA criteria 129 10‐23 y NR CV: odds of having increased thickness of carotid IMT increased by 29%/y since diagnosis
35 Cross sectional Japan, 1 study site—Yokohama City University Medical Center Japan Diabetes Society Criteria 43 with T2D; 33 with T1D Mean 16.5 y (3.5 SD) with T2D; 14.9 y (3.7 SD) with T1D NR Mean 3.8 y (2.8 SD) for patients with T2D and 5.7 y (4.5 SD) for patients with T1D PAI‐1 (marker for promotion of atherosclerosis) was found to be significantly higher in patients with T2D (32.9 ng/mL vs 19.3 ng/mL in T1D)
36 Single‐observer, blinded New Zealand, 1 study site NR 8 with T2D; 11 with T1D; 20 CG 12‐18 y (girls only) NR Assessment completed at a mean diabetes duration of 20 months for T2D; 66 months for T1D The cardiac structure and function showed abnormalities compared with T1D and controls

Abbreviations: ADA, American Diabetes Association; BG, blood glucose; CG, control group; CV, cardiovascular; CVD, CV disease; HbA1c, glycated hemoglobin; ICD‐9‐CM, International Classification of Diseases, 9th Revision, Clinical Modification; IMT, intima‐media thickness; LE, life expectancy; LV, left ventricle; NR, not reported; OGTT, oral glucose tolerance test; PAI‐1, plasminogen activator inhibitor‐1; SD, SD; T1D, type 1 diabetes; T2D, type 2 diabetes; VPT, vibration perception threshold; WHO, World Health Organization; y, year(s).

a

Data from abstract only as the full text is in Japanese.