Lancet Reg Health Eur. 2026 Jul 22;67:101764. doi: 10.1016/j.lanepe.2026.101764. eCollection 2026 Aug.
ABSTRACT
BACKGROUND: Early-onset type 2 diabetes is associated with aggressive disease progression, long-term health burden and reduced life expectancy. Trends in incidence have not been comprehensively described.
METHODS: Using data from the English National Diabetes Audit, age-standardised incidence rates for adults with type 2 diabetes were calculated by age, sex, and ethnicity between 2011 and 2024. Poisson regression models were created to study incidence over time. Annual change in median BMI within 26 weeks of diagnosis were calculated.
FINDINGS: Age-standardised incidence increased among adults aged 20-29 years (RR 1.021 [95% CI 1.017-1.026] per year in males, 1.030 [1.026-1.034] in females) and 30-39 years (1.013 [1.012-1.015] in males, 1.03 [1.028-1.032] in females). Incidence increased minimally in males aged 40-59 years (1.006 [1.005-1.006]), was rising in females (1.018 [1.017-1.019]) and declined in males and females aged 60-79 years (0.983 [0.983-0.984] in males, 0.985 in females 0.985 [0.984-0.985]). Increasing incidence in young adults were observed in all sex and ethnicity subgroups except Asian males (20-39-years) but highest rates were in White females (30-39-years) and Black females (20-29). BMI at diagnosis increased in all subgroups over time but was highest in younger adults and higher in females than males. The annual change in younger adults was double that of older (20-29 year-old-males +0.17 kg/m2/year [0.08-0.26] and females +0.17 [0.09-0.26]; 30-39-year-old males +0.21 [0.18-0.24] and females +0.20 [0.16-0.24]; 40-59 year-old-males +0.06 [0.04-0.07] and females +0.09 [0.06-0.12]; 60-79 year old males +0.08 [0.06-0.09] and females +0.11 [0.08-0.13]).
INTERPRETATION: Since 2011, incidence of type 2 diabetes has risen significantly in young adults across most ethnicity and sex subgroups (especially females) despite minimal changes or declining rates at older ages. This trend parallels greater increases in BMI-at-diagnosis in young people, highlighting a shift in disease burden and the urgent need for earlier prevention, and focused obesity interventions in early-life.
FUNDING: Wellcome Trust.
PMID:42577376 | PMC:PMC13453952 | DOI:10.1016/j.lanepe.2026.101764