Diabetes Affects Young Adults at Alarming Rates: Study Reveals
Health Insurance Data Shows Surge in Diabetes Cases Among Millennials
It has long been believed that diabetes primarily affects individuals in middle age or older. However, recent statistics from the Health Insurance Review and Assessment Service have revealed a concerning increase in young patients being diagnosed with the disease. Comparing data from 2017 to 2021, there has been a staggering 57% rise in hospital visits by individuals in their 20s for diabetes, with patient numbers reaching 40,855. Those in their 30s also experienced a notable increase of approximately 26%. These alarming figures challenge the notion that diabetes is exclusive to older adults.
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Increased Risk Factors for Diabetes Among Adults
Medical professionals emphasize the importance of being vigilant regarding diabetes risk factors, particularly among adults. Key risk factors include obesity, family history, and advanced age. Recent studies have also identified high residual cholesterol, cholecystectomy (gallbladder removal), and non-alcoholic fatty liver disease as potential contributors to the development of diabetes in young adults.
“High Residual Cholesterol Doubles the Risk of Diabetes in Adults”
A team led by Professor Kang Joon-gu from Hallym University Sacred Heart Hospital’s Department of Endocrinology conducted a study investigating the correlation between residual cholesterol levels and diabetes. The research followed approximately 8.5 million adults without diabetes who underwent health checks in 2009 for a decade. Residual cholesterol refers to cholesterol found in very low-density lipoproteins (VLDL) or intermediate-density lipoproteins (IDL).
The study demonstrated that, after nine years, the incidence of diabetes among individuals with high residual cholesterol levels (30 mg/dL or higher) reached 13.3 cases per 1,000 person-years. In contrast, those with low cholesterol levels (14 mg/dL or lower) experienced only 3.1 cases per 1,000 person-years. Even after adjusting for various factors such as age, sex, body mass index, and smoking, the group with high residual cholesterol levels had a twofold higher risk of developing diabetes compared to the group with low residual cholesterol levels.
Of particular note is the significant impact of residual cholesterol on diabetes in younger individuals. When considering other risk factors, the study found that compared to the low residual cholesterol group, the high residual cholesterol group had a 1.20-fold higher risk of diabetes in individuals aged 70 and above, a 1.51-fold higher risk in those aged 60 to 69, a 1.90-fold higher risk in the 50 to 56 age group, a 2.47-fold higher risk in the 40 to 49 age group, and a striking 3.07-fold higher risk in individuals aged 39 and below, including a 3.06-fold higher risk between the ages of 20 and 29.
The study’s findings were recently published in the esteemed international journal Diabetes Care in 2023.
“Non-Alcoholic Fatty Liver Disease Puts Young Women at Nearly Five Times Higher Risk of Diabetes”
A research team led by Ryu Seung-ho from Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital’s Data Management Center conducted a study revealing that young women with non-alcoholic fatty liver disease (NAFLD) face a significantly increased risk of developing diabetes. The study analyzed data from 245,054 adults without diabetes who underwent health checks between 2011 and 2018. The results, published in the prestigious international journal Hepatology, highlighted a strong correlation between NAFLD and diabetes.
The study found that premenopausal women with NAFLD were at a 4.6 times higher risk of developing diabetes compared to a healthy group without NAFLD. Postmenopausal women with NAFLD faced a 2.7 times higher risk, while men with NAFLD had a 2.2 times higher risk. Furthermore, the study revealed that the risk increased correspondingly with the severity of non-alcoholic fatty liver disease.
“Cholecystectomy Raises Diabetes Risk, Even in Young Adults”
Studies have shown that individuals who have undergone cholecystectomy (gallbladder removal) have a 20% increased risk of developing diabetes compared to those who have not. A research team led by Kang Joon-gu from the Department of Endocrinology at Hallym University’s Sacred Heart Hospital followed a group that underwent cholecystectomy between 2010 and 2015, as well as a control group of the same age and sex without the procedure, up until 2019.
The study revealed that the increased risk of developing diabetes due to cholecystectomy was 29%, surpassing the risk associated with obesity, which stood at 24%. This highlights the greater risk of diabetes following cholecystectomy compared to obesity. Specifically, obese individuals who underwent cholecystectomy faced a 41% higher risk of developing diabetes compared to non-obese individuals without the procedure.
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There is a strong perception that ‘diabetes’ is a disease that appears in middle age. However, the recent increase in young patients is unusual. If you look at the Health Insurance Review and Assessment Service data, in 2021, 40,855 people in their 20s visited the hospital with diabetes. This is an increase of around 57% compared to 2017. Patients in their 30s increased by around 26% during the same period. Looking at this progress, it can no longer be said that no adult is free of diabetes.
Diabetes｜Source: Getty Image Bank
Adults with these characteristics are at increased risk of diabetes
In particular, experts emphasize the need for special attention if you have diabetes risk factors. Representative diabetes risk factors include obesity, family history, and old age. In addition, recent studies have found that high residual cholesterol, cholecystectomy, and non-alcoholic fatty liver disease may increase the risk of diabetes in young adults.
“Adults with high residual cholesterol up to double the risk of diabetes”
Hallym University Sacred Heart Hospital Department of Endocrinology Professor Kang Joon-gu’s team investigated the relationship between residual cholesterol levels and diabetes by following approximately 8.5 million adults without diabetes who had health checks in 2009 for 10 years. Residual cholesterol refers to cholesterol in very low density lipoproteins (VLDL) or intermediate density lipoproteins (IDL).
As a result of the study, the incidence of diabetes after 9 years in people with a high level of residual cholesterol (30 mg/dL or more) and a low level of cholesterol (14 mg/dL or less) per 1,000 person-years (person-year refers to the unit of observation for the person-year) 13.3 cases and 3.1 cases, respectively, showing a difference of approximately 3.3 times. Even after adjusting for age, sex, body mass index, smoking, drinking, high blood pressure, chronic kidney disease, dyslipidemia, and fasting blood sugar, the group with 30 mg/dL or more was about twice higher than the group with 14 mg/dL or less.
In particular, it is worth noting that residual cholesterol has a significant effect on diabetes at a younger age. After adjusting for various risk factors, the risk of developing diabetes in the high residual cholesterol group compared to the low residual cholesterol group is 1.20 times at age 70 and over △ 1.51 times at 60 to 69 △ 1.90 times in the 50 to 56 years △ 2.47 times between 40 and 49 years △ 30 It was found that the effect of residual cholesterol on the onset of diabetes is greater in younger people, such as 3.07 times at 39 years and 3.06 times between 20 and 29 years.
The results of this study were published in the latest issue of Diabetes Care, an international journal at the SCI level, in 2023.
“Young women with non-alcoholic fatty liver disease have 4.6 times the risk of diabetes”
Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Data Management Center Ryu Seung-ho’s research team has published a study showing that even young women with non-alcoholic fatty liver are at increased risk of developing diabetes. The results of the study are the results of analyzing the correlation between non-alcoholic fatty liver and diabetes in 245,054 adults without diabetes who had health checks between 2011 and 2018, and were published in the international journal ‘Hepatology’.
The results of the study showed that the presence of NAFLD increases the risk of diabetes 4.6 times in premenopausal women, 2.7 times in postmenopausal women, and 2.2 times in men compared to a healthy group without NAFLD appearing. In addition, these results were found to be more pronounced as the severity of non-alcoholic fatty liver disease increased.
“Diabetes risk increases after cholecystectomy even at a young age”
Studies have shown that people who have had a cholecystectomy have a 20% higher risk of developing diabetes compared to those who have not had a cholecystectomy. A research team led by Kang Joon-gu from the Department of Endocrinology at Hallym University’s Sacred Heart Hospital followed up to 2019 a group that had a cholecystectomy between 2010 and 2015 and a group of the same sex and age but without a cholecystectomy.
According to the study, the increased risk of developing diabetes due to cholecystectomy was 29%, which was higher than the increased risk of developing diabetes due to obesity (24%). This suggests that the risk of developing diabetes is greater with cholecystectomy than with obesity. Specifically, obese people who had a cholecystectomy had up to a 41% higher risk of developing diabetes than non-obese people who did not have a cholecystectomy.
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