Cardiovascular Complications, Kidney Failure, and Mortality in Young-Onset Type 1 and Type 2 Diabetes: Data From the Korean National Health Insurance Service

OBJECTIVE To explore all-cause mortality and the incidence of cardiovascular and renal complications among patients with young-onset diabetes in South Korea using a nationwide registry database. RESEARCH DESIGN AND METHODS Data were collected from the Korean National Health Insurance Service–National Sample Cohort database from 2006 to 2019 for patients aged ≤30 years with type 1 diabetes (T1D) or type 2 diabetes (T2D). The incidence rates of cardiovascular complications (myocardial infarction [MI] and stroke) and kidney failure, as well as all-cause mortality, were compared with those in the general population. RESULTS This study included 513,633 participants, comprising 413 with T1D, 1,250 with T2D, and 511,970 control individuals. After adjusting for sex, age, family income, hypertension, and dyslipidemia, the hazard ratio (HR) for MI was 6.76 (95% CI 2.44–18.72) and 5.07 (95% CI 2.48–10.36) for T1D and T2D, respectively. The HR for stroke was 4.65 (95% CI 1.70–12.71) and 3.30 (95% CI 1.67–6.53) for T1D and T2D, respectively. The HR for kidney failure was 20.92 (95% CI 11.40–38.39) and 2.78 (95% CI 1.37–5.64) for T1D and T2D, respectively. The mortality risk was significantly higher in patients with T1D (3.69; 95% CI 1.95–6.98) and T2D (3.06; 95% CI 2.02–4.63) than in the control group. The mortality risk was highest in the T2D subgroup of participants aged <20 years at enrollment (10.70; 95% CI 4.41–25.94). CONCLUSIONS In South Korea, patients with young-onset diabetes are at high risk of cardiovascular complications, kidney failure, and death.