Age-, sex- and ethnicity-related differences in body weight, blood pressure, HbA1c and lipid levels at the diagnosis of type 2 diabetes relative to people without diabetes

Aims/hypothesis: To determine how weight patterns together with glycaemia, blood pressure and lipids vary at diagnosis of diabetes by age, sex and ethnicity.

Methods: Using the UK Clinical Practice Research Datalink, we identified people with type 2 diabetes (n=187,601) diagnosed 1998-2015, and compared their weights, HbA1c, blood pressure and lipid levels with age-matched people without diabetes (n=906,182), by sex and ethnic group.

Results: Younger age at diagnosis was associated with greater adjusted mean difference (95% CI) in weight between those with versus without type 2 diabetes being 18.7 (18.3, 19.1) kg at 20-39 years of age but 5.3 (5.0, 5.5) kg ≥80 years; weight differentials were maximal in white women, and around double in whites compared with South Asians and Blacks. Despite lower absolute values, blood pressure differences were also greatest at younger age of diabetes onset: 7 (6, 7) mmHg at age 20-39 years versus -0.5 (-0.9, -0.2) at ≥80 years of age, and greatest in whites, and especially in women. Triacylglycerol level differences were greatest in younger men. Finally, HbA1c levels were also higher with younger onset diabetes, particularly in Blacks.

Conclusions/interpretation: At diagnosis of type 2 diabetes, compared to controls, weight and blood pressure differentials were greater in: younger compared to older people; in women compared to men and in whites compared to South Asians and Blacks. These differences were observed even though South Asians and Blacks tend to develop diabetes a decade earlier with either similar or greater dysglycaemia. These striking patterns may have implications for management and prevention.