Metabolic, immunological and clinical characteristics in newly diagnosed Asian diabetes patients aged 12-40 years

Aim: To describe the clinical, biochemical and immunological characteristics of young-onset diabetes in Asia. Methods: Clinical, biochemical and immunological variables were assessed in 919 newly diagnosed (duration less than 12 months) young onset Asian diabetic patients aged between 12 and 40 years. The subjects constituted 57% Chinese, 29% Indians and 14% Malays, recruited from diabetes centres in China, Hong Kong, India, Malaysia and Singapore. Results: The mean age (± SD) was 31.6 ± 7.2 years, with the majority (66%) in the 31-40 years age group. Mean body mass index (BMI) (± SD) was 25.3 ± 5.0 kg/m² with 47% exceeding the suggested Asian cut-off point for obesity (BMI > 25). Ethnic difference in clinical characteristics included BMI, blood pressure, mode of treatment and degree of insulin resistance. Most patients had a clinical presentation of Type 2 diabetes. About 10% had a classical combination of ketotic presentation, presence of autoimmune-markers and documented insulin deficiency indicative of Type 1 diabetes. Forty-eight percent were receiving oral hypoglycaemic agents (OHAs) while 31% were on diet only, 18% were receiving insulin and 2% were on a combination of insulin and OHA. Conclusion: Young onset diabetes patients in Asia represent a heterogenous group in terms of their clinical and biochemical characteristics and classical Type 1 diabetes is relatively uncommon. The 5-year follow up study will determine the progress of these patients and help to clarify the natural history.