The rapidly increasing incidence of type 2 diabetes and macrovascular and microvascular complications disproportionately affects younger age groups: a decade of evidence from an international federated database

TY - JOUR

T1 - The rapidly increasing incidence of type 2 diabetes and macrovascular and microvascular complications disproportionately affects younger age groups

T2 - a decade of evidence from an international federated database

AU - Anson, Matthew

AU - Henney, Alex E.

AU - Edwards, Harry

AU - Ibarburu, Gema H.

AU - Mordi, Ify

AU - Jaffar, Shabbar

AU - Garrib, Anupam

AU - Lip, Gregory Y. H.

AU - Wang, Duolao

AU - Nabrdalik, Katarzyna

AU - Perkins, Bruce A.

AU - Cuthbertson, Daniel J.

AU - Alam, Uazman

N1 - Copyright © 2025 The Author(s).

PY - 2025/10

Y1 - 2025/10

N2 - Aims To characterise recent trends in incidence and prevalence of type 2 diabetes (T2D) associated complications, and their relative impact across the lifespan. Methods We conducted a retrospective cohort study using the TriNetX global federated database. Incidence and prevalence of T2D and associated complications: ischaemic heart disease (IHD), heart failure, cerebral infarction, neuropathy, nephropathy, and retinopathy were assessed between 2012 and 2023. Incidence odds ratios (IOR) were calculated by age group. Results 7,918,666 individuals had T2D. The IOR (95 % CI), comparing individuals aged ≥ 85 years to < 35 years decreased for all complications from 2012 to 2023: IHD [IOR 6.82, (6.40, 7.26) to IOR 2.27 (2.17, 2.38)], heart failure [IOR 5.38, (5.03, 5.75) to IOR 1.80 (1.72, 1.89)], cerebral infarction [IOR 3.06, (2.76, 3.40) to IOR 1.45 (1.34, 1.57)], neuropathy [IOR 0.84, (0.74, 0.95) to IOR 0.47 (0.44, 0.49)], nephropathy [IOR 1.14, (1.03, 1.27) to IOR 0.90 (0.87, 0.94)] and retinopathy [IOR 0.56, (0.50, 0.63) to IOR 0.27 (0.25, 0.29)]. Conclusions Rising rates of T2D associated complications in younger adults signal an emerging epidemic of early-onset comorbidity with substantial lifetime burden. These findings emphasise the urgent need for earlier detection, aggressive risk factor management, and targeted prevention strategies in younger populations.

AB - Aims To characterise recent trends in incidence and prevalence of type 2 diabetes (T2D) associated complications, and their relative impact across the lifespan. Methods We conducted a retrospective cohort study using the TriNetX global federated database. Incidence and prevalence of T2D and associated complications: ischaemic heart disease (IHD), heart failure, cerebral infarction, neuropathy, nephropathy, and retinopathy were assessed between 2012 and 2023. Incidence odds ratios (IOR) were calculated by age group. Results 7,918,666 individuals had T2D. The IOR (95 % CI), comparing individuals aged ≥ 85 years to < 35 years decreased for all complications from 2012 to 2023: IHD [IOR 6.82, (6.40, 7.26) to IOR 2.27 (2.17, 2.38)], heart failure [IOR 5.38, (5.03, 5.75) to IOR 1.80 (1.72, 1.89)], cerebral infarction [IOR 3.06, (2.76, 3.40) to IOR 1.45 (1.34, 1.57)], neuropathy [IOR 0.84, (0.74, 0.95) to IOR 0.47 (0.44, 0.49)], nephropathy [IOR 1.14, (1.03, 1.27) to IOR 0.90 (0.87, 0.94)] and retinopathy [IOR 0.56, (0.50, 0.63) to IOR 0.27 (0.25, 0.29)]. Conclusions Rising rates of T2D associated complications in younger adults signal an emerging epidemic of early-onset comorbidity with substantial lifetime burden. These findings emphasise the urgent need for earlier detection, aggressive risk factor management, and targeted prevention strategies in younger populations.

KW - Type 2 diabetes

KW - Epidemiology

KW - Microvascular

KW - Macrovascular

U2 - 10.1016/j.diabres.2025.112431

DO - 10.1016/j.diabres.2025.112431

M3 - Article

C2 - 40858214

SN - 0168-8227

VL - 228

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

M1 - 112431

ER -