Diana Hedevang Christensen, MD, PhD

Aarhus University Hospital, Dept. of Epidemiology and Aarhus University Hospital, Dept. of Endocrinology and Internal Medicine

Title of project

Early-onset type 2 diabetes: Distinct phenotype, socioeconomic inequalities, and diabetes complications

Abstract

The number of younger and middle-aged people with early-onset (≤55 years) type 2 diabetes (T2D) is rapidly increasing, and early-onset T2D may disproportionally affect persons with low socioeconomic position. Early-onset T2D may predict increased rates of diabetes complications, including microvascular complications (eye, kidney, and nerve diseases) and cancer, but little is known about the underlying mechanisms. Therefore, experts have called for urgent action to address this rising public health concern. We hypothesize that early-onset T2D
is a distinct, clinically severe phenotype characterized by socioeconomic deprivation, mental health issues, lifestyle risk behaviors, and a resulting high allostatic load, i.e., cumulative biological burden measured through metabolic, inflammatory, and cardiovascular factors. We hypothesize that these factors cumulate and interact in mediating a worse prognosis of earlyonset T2D, with low socioeconomic position as a key driver. To investigate this, we will take advantage of unique data-rich Danish populations-based registries to conduct large nationwide
studies that can substantially increase our understanding of the early-onset T2D/socioeconomic position/prognosis relationships. Within these large studies, we will leverage two uniquely granulated Danish datasets; The Danish Centre for Strategic Research in T2D (DD2) and the Danish National Health Survey. These datasets hold detailed data on social, behavioral/lifestyle, and mental health factors as well as laboratory, genetic, and clinical data
including anthropometric data, and will enable in depth of the proposed hypotheses within T2D subpopulations. This research project overall aims to 1) Provide a deep characterization of the socioeconomic and clinical phenotype of early-onset T2D, 2) Examine the impact of socioeconomic position on development of microvascular diabetes complications (kidney, eye, and nerve diseases) in early-onset T2D, and 3) Investigate the impact of socioeconomic position on risk of cancer in early-onset T2D.

Diana Hedevang Christensen, MD, PhD

20%-financed clinical postdoctoral fellowship

Principal investigator

Reimar W. Thomsen, Aarhus University Hospital, Dept. of Epidemiology

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