Adapted from BMJ 4 Nov 2023 The Bottom Line: The time to tackle rising type 2 diabetes is T2DaY by Partha Kar consultant in diabetes and endocrinology Portsmouth Hospitals NHS Trust.
England’s 18-40 year olds with type two diabetes now exceed those with type one. In the not too distant past, type two diabetes was associated with middle age rather than youth. Causes for this increase include lifestyle, environmental and societal factors.
About 4% of people with type two diabetes are now under 40 years of age. Worryingly, this rise in type two diabetes is accelerating fastest in the under 40s. It tends to affect people who are socioeconomically deprived, are in minority ethnic groups, and in those with obesity. And the complications are aggressive.
There tends to be a greater risk of the vascular complications of diabetes compared to later onset type two diabetes. There are poorer pregnancy outcomes compared to type one diabetes. If you are diagnosed at the age of 30, you can expect to live 14 fewer years of life. At diagnosis, multi-morbidity is common and even if not present, can develop rapidly.
The 18 to 40 age group are often in education or working. They face transitions from the family home, to university or the workplace. Money tends to be tight. They are considering buying homes or renting. They may pairing off with partners, and they may already have a young family or be planning to start. Increasingly they can’t afford to buy a home, and put off having children till older ages.
There are now about 140,000 young adults with type two diabetes. It is important that the correct diagnosis is made at the outset, and that pregnancy planning and outcomes are prioritised. Dr Shivani Misra from Imperial College London, has published a Type 2 Diabetes in the Young programme that she hopes will be adopted in order to improve the outlook for these young people and their families.
Meanwhile, Government initiatives are needed to reduce socio-economic deprivation, improve healthy food options, improve space for exercise, and improve people’s motivation to look after themselves.
Diabetes Diet 
It’s staggering that there are more 18 to 40 year old people in England with type 2 diabetes mellitus than with type 1 diabetes mellitus.
I expect the result would be similar here in Australia and probably replicated in the USA and Canada.
I’m watching my father die from the complications of type 2 diabetes mellitus. He was a once a brilliant man, a general practitioner with a great thinking brain. Sadly, no more.
The current emphasis on carbohydrate-laden ultra-processed “food” has to stop. It’s madness.
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It boggles my mind to consider what the number of type 2’s in the US is. I used to lead groups for non-compliant fragile diabetic teenagers at UCSD. One person came up to me several years later, showed me her dialysis scars, and asked me if I remembered her.
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