P-448: Clinical characteristics, metabolic features, and early microvascular complications in young-onset diabetes: insights from bach mai hospital, a tertiary referral center
N Trang Nhung, N Quang Bay, N Khoa Dieu VanAbstract
Introduction
Young-onset diabetes is associated with early complications, yet Southeast Asian data are scarce.
Objectives
To describe diabetes subtypes, metabolic features, treatment patterns, and microvascular complications in young-onset diabetes.
Methods
In a cross-sectional study, 246 participants diagnosed with diabetes between ages 18 and 35 years and enrolled at ages 18 - 45 years were recruited from January 2024 to August 2025. Clinical, biochemical, and complication data were analyzed.
Results
The study population had a male-to-female ratio of 1:1.14, with no statistically significant difference between genders (p > 0.05). Mean age at diagnosis was 28.1 ± 5.7 years. Type 2 diabetes (T2D) predominated (72.0%), followed by type 1 (T1D) (17.1%), pancreatogenic diabetes (8.9%) and other types (2.0%). At diagnosis, compared with T2D, patients with T1D were diagnosed younger (22.8 ± 5.5 vs 28.9 ± 5.1 years, p < 0.001) and had a higher prevalence of diabetic ketoacidosis at presentation (78.6% vs 17.5%, p < 0.001). Mean HbA1c was 9.2 ± 2.7%, with only 15.9% achieving the individualized HbA1c target of < 6.5%. Obesity, fatty liver disease, dyslipidemia, and hypertension were present in 34.1%, 63.0%, 86.6%, and 20.3%, respectively. Preventive treatment remained suboptimal, with only 64.0% of hypertensive patients receiving antihypertensive therapy and 44.1% of those with dyslipidemia receiving lipid-lowering treatment. Regarding microvascular complications, diabetic kidney disease, retinopathy, and neuropathy were present in 27.6%, 16.7%, and 26.4%, respectively. Overall, 42.3% had ≥ 1 microvascular complication and 8.9% had all three. The first microvascular complication occurred after 4.7 ± 3.7 years, earlier in T2D than T1D (4.1 vs 7.3 years, p = 0.002).
Conclusions
Young-onset diabetes was characterized by poor glycemic control, high cardiometabolic burden, undertreatment of risk factors and early microvascular complications, supporting early screening and intensive multifactorial care.