Time-to-complication and trajectory mapping of microvascular complications in youth-onset type 2 diabetes: A scoping review
Keywords:
Youth-onset type 2 diabetes, Microvascular complications, Time-to-complication disease, Trajectory scoping reviewAbstract
Youth-onset type 2 diabetes mellitus (T2DM) has emerged as a growing global health concern and is characterized by a more aggressive disease course than adult-onset T2DM. This scoping review aimed to map existing evidence on the timing of onset and trajectories of microvascular complications in youth-onset T2DM. The review was conducted in accordance with the Joanna Briggs Institute methodology and reported following the PRISMA-ScR guidelines. Searches were performed in PubMed/MEDLINE, Scopus, and CINAHL covering publications from 2016 to 2026. A total of 107 records were identified, yielding six longitudinal studies predominantly derived from the TODAY, TODAY2, and SEARCH cohorts that met the inclusion criteria. The review indicates that microvascular complications can manifest as early as the time of diagnosis or within the first 3–5 years of disease onset. Cumulative incidences of diabetic kidney disease (DKD), diabetic retinopathy (DR), and diabetic peripheral neuropathy (DPN) were 54.8%, 51.0%, and 32.4%, respectively, over a mean follow-up of 13.3 years. These complications progress rapidly during adolescence and young adulthood. Trajectory analysis reveals that the early hyperfiltration group exhibits the highest risk of developing albuminuria. These findings address a critical knowledge gap regarding the time-to-complication and disease trajectory in youth-onset T2DM. The results further support the pivotal role of nurses in implementing systematic, proactive screening from the early stages of disease, and underscore the need for evidence-based clinical guidelines for complication surveillance in primary and tertiary healthcare settings.
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