Characteristics associated with early- vs. later-onset adult diabetes: The CARDIA study

Eun Seok Cha, Francisco J. Pasquel, Fengxia Yan, David R. Jacobs, Sandra B. Dunbar, Guillermo Umpierrez, Yuni Choi, James M. Shikany, Michael P. Bancks, Jared P. Reis, Melissa Spezia Faulkner

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Aims: Differences in risk profiles for individuals with early- (<40 years old) vs. later-onset (≥40 years old) diabetes were examined. Methods: A nested case-comparison study design using 30-year longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study was used. Survey data (socio-demographics, family history, medical records, and lifestyle behaviors), obesity-related measures (body mass index, weight), blood pressure, and laboratory data (insulin, fasting glucose, 2-h glucose, and lipids) were used to examine progression patterns of diabetes development in those with early-onset vs. later-onset diabetes. Results: Of 605 participants, 120 were in early-onset group while 485 were in later-onset group. Early-onset group had a lower A Priori Diet Quality Score, but not statistically significant at baseline; however, the between-group difference became significant at the time that diabetes was first detected (p = 0.026). The physical activity intensity score consistently decreased from baseline to the development of diabetes in both the early- and later-onset groups. Early-onset group showed more dyslipidemia at baseline and at the time that diabetes was first detected, and rapid weight gain from baseline to the development of diabetes. Conclusions: Emphases on lifestyle modification and risk-based diabetes screening in asymptomatic young adults are necessary for early detection and prevention.

Original languageEnglish (US)
Article number109144
JournalDiabetes Research and Clinical Practice
StatePublished - Dec 2021

Bibliographical note

Funding Information:
This research project is supported by the Diabetes Action Research and Education Foundation and the Korea Research Foundation (NRF-2019R1A2C1087199). The Coronary Artery Risk Development in Young Adult Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201800005I & HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I).

Publisher Copyright:
© 2021


  • Early prevention
  • Risk prediction
  • Type 2 diabetes
  • Young adults

PubMed: MeSH publication types

  • Journal Article


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