REZUMAT
Introducere: In prezent este in plina desfasurare la nivel mondial o adevarata epidemie de diabet zaharat (DZ), numarul de cazuri fiind in crestere peste tot in lume, indiferent de varsta si de categoria socioeconomica. Debutul DZ tip 2 la varste tinere se insoteste de un risc mai mare de complicatii cronice micro si macrovasculare decat daca boala a debutat la subiectii mai in varsta. Obiectiv: Stabilirea trasaturilor la debut a si a prevalentei factorilor de risc cardiovasculari la un grup de pacienti cu DZ tip 2 diagnosticat la varste cuprinse intre 18 si 40 de ani si compararea acestora cu un grup de subiecti cu DZ tip 1 de aceeasi varsta, diagnosticati in aceeasi perioada. Pacienti si metoda: Au fost inrolati in studiu 283 pacienti cu DZ tip 2 (67.1% barbati) si 48 pacienti cu DZ tip 1 (60.4% barbati) cu varste cuprinse intre 18 si 40 de ani, diagnosticati intre ianuarie 2006 si decembrie 2008 si inregistrati la Centrul de Diabet Timisoara. Au fost colectate urmatoarele date din fisele de urmarire ale pacientilor: sex, varsta la diagnostic, tipul DZ, circumstante de diagnostic, inaltimea, greutatea maxima si greutatea la diagnostic, glicemia la diagnostic, valorile lipidelor serice, prezenta HTA, schema de tratament si complicatiile DZ. Pentru fiecare grup am calculat distributia in functie de sex, varsta medie la debut, IMC-ul mediu, distributia in functie de IMC, valorile medii ale lipidelor, prevalenta factorilor de risc cardiovascular si a complicatiilor cronice, prevalenta sindromului metabolic. Datele au fost prelucrate statistic, pragul de semnificatie fiind de 0,05. Rezultate: Varsta pacientilor cu DZ tip 1 este semnificativ mai mica fata de cea a pacientilor cu DZ tip 2 (30,2±17,0 vs. 36,3±3,6 ani, p<0,0001). Majoritatea pacientilor cu DZ tip 2 au fost diagnosticati prin masurarea de rutina a glicemiei à jeun si prin TTGO, in timp ce in DZ tip 1 cea mai frecventa circumstanta de diagnostic a fost cetoza/cetoacidoza diabetica. Obezitatea, dislipidemia si hipertensiunea au fost semnificativ mai frecvente la subiectii cu DZ tip 2. Complicatiile cronice au fost rar intalnite. Sindromul metabolic a fost prezent la 67,8% din subiectii cu DZ tip 2 si la 10,5% din cei cu DZ tip 1 (p<0,001). Concluzii: DZ tip 2 este o afectiune obisnuita la grupa de varsta 18-40 de ani, afecteaza mai ales subiectii obezi si supraponderali si se asociaza adesea cu alti factori de risc cardiovasculari, chiar de la diagnostic. intr-o mai mica masura, acesti factori de risc sunt prezenti si la subiectii cu DZ tip 1.

ABSTRACT
Background: A global diabetes epidemic is currently ongoing, with the number of cases increasing worldwide in all age groups and all socio-economic classes. Young adults with early onset T2DM are more likely to develop chronic microvascular and macrovascular complications than older adults with type 2 diabetes. Aims: To describe the onset characteristics and to assess the prevalence of cardiovascular risk factors in a group of patients diagnosed with T2DM at ages between 18 and 40 years and to compare them with type 1 DM (T1DM) patients in the same age group and diagnosed in the same period of time. Patients and methods: Study groups consisted of 283 T2DM (67.13% males) and 48 T1DM patients (60.4% males) aged between 18 and 40 years, diagnosed between January 2006 and December 2008 at the Diabetes Center Timisoara. Patients data were recorded from the follow-up charts and consisted of gender, age at diagnosis, diabetes type, diagnosis circumstances, height, weight at diagnosis, maximal weight, blood glucose at diagnosis, lipid panel, presence of hypertension, diabetes treatment, presence of chronic diabetes complications, and concomitant diseases. For each group we calculated gender distribution, mean age at onset, distribution depending on the type of onset, average BMI, distribution based on weight status, mean TC, TG and HDLc, prevalence of cardiovascular risk factors, metabolic syndrome (MetS) and of chronic complications. Data was statistically processed with a threshold for significance of 0.05. Results: Patients with T1DM were significantly younger compared to those with T2 DM (30.2±17.0 years vs. 36.3±3.6 years, p<0.0001). Most patients from the T2DM group were diagnosed by routine fasting plasma glucose measurement and by OGTT. In T1DM, disease was most commonly diagnosed in the presence of ketosis/ketoacidosis. Obesity, abnormal lipid levels and hypertension were more prevalent in T2DM group. Chronic complications were rarely encountered. MetS was present in 67.8% of T2DM patients vs. 10.5% in T1DM subgroup (p<0.001). Conclusions: T2DM is a common disease in the 18-40 years age group. It affects mostly obese and overweight individuals and is very frequently associated with other cardiovascular risk factors, even from the diagnosis. To a lesser extent, cardiovascular risk factors are also present in T1DM.