Explaining the high prevalence of young-onset diabetes among Asians and Indigenous Australians

Rare and common genetic variants may interact with environmental factors to cause young-onset diabetes

While the prevalence of young-onset diabetes is rising worldwide, it is increasing particularly rapidly in Asian and Indigenous Australian populations. In Asia, one in five people with diabetes is diagnosed before the age of 40;1 in Australia, Indigenous Australians are six times as likely to develop diabetes during adolescence or childhood as Australians of European background.2 People with young-onset diabetes comprise a heterogeneous group, with aetiologies including classic type 1 diabetes, latent autoimmune diabetes in adults (LADA), type 2 diabetes, and the rarer monogenic maturity-onset diabetes of the young (MODY).3 Differentiating these subtypes is challenging, particularly in 20–40-year-old patients, among whom the proportions of the subtypes may vary by ethnic group.