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General Endocrinology

SAT-852 - Rising Burden of Early-Onset Type 2 Diabetes and Health Disparities in a Middle-Income Country: A Nationwide Population-Based Study

Saturday, June 13, 2026
9:30 AM - 4:30 PM CT


Introduction: The epidemiological transition of Type 2 Diabetes Mellitus (T2DM) in middle-income countries includes a rise in early-onset cases (10–39 years), associated with greater risk of multisystem complications due to prolonged glycemic exposure. Early-onset T2DM presents a more aggressive phenotype, with faster beta-cell decline and higher cardiovascular risk. Despite its severity, gaps remain in understanding how social determinants influence disparities in healthcare access and outcomes compared to late-onset T2DM (≥40 years).

Objective: To compare the burden and temporal trends of early-onset diabetes hospitalizations (10–39 years) versus late-onset cases in Brazil, analyzing sex-specific patterns, regional disparities, and healthcare utilization using national data.

Methods: Ecological, retrospective, descriptive study using secondary data from the Hospital Information System of the Brazilian Unified Health System (SIH/SUS) via DATASUS. Hospitalizations for diabetes (ICD-10 E10–E14) from 2015 to 2025 were analyzed by age group, sex, region, and federal unit, including mean length of stay.

Results: From 2015 to 2025, Brazil recorded 265,741 hospitalizations in individuals aged 10–39 and 1,223,080 in those ≥40 (82.15%). Among younger individuals, rates were highest in 30–39 years (33.44%), followed by 20–29 (25.37%) and 10–14 (15.27%). In ≥40, highest prevalence occurred in 60–69 years (29.47%), followed by 50–59 years (23.63%) and 70–79 years (22.22%). Females predominated in early-onset (57.01%), while males predominated in late-onset (52.16%). The Southeast region, especially São Paulo, concentrated most cases. Mean hospital stay was 5.6 days in ≤39 (longest in 30–39 years: 6.1) and 6.5 days in ≥40 years (longest in 60–69 years: 6.8). The longest stays occurred in Roraima (10.5 days, 30–39 years ) and Rio Grande do Norte (13.9 days, 60–69 years ), the latter with the highest overall average (12.3 days).

Conclusion: Hospitalizations were predominantly concentrated in the population over 40 years of age, but a substantial burden was observed among individuals aged 10 to 39 years, particularly in the 30-39 age group. Early-onset cases were predominantly female, while late-onset cases were more frequent in men, suggesting gender disparities specific to each age group. The Southeast region, especially São Paulo, concentrated the highest number of hospitalizations, indicating a regional concentration of the disease burden and/or access to health services. Although younger individuals had shorter average hospital stays, marked regional heterogeneity was observed, with disproportionately prolonged hospitalizations in some states. These findings highlight the growing relevance of early-onset diseases, reinforce the need for specific prevention strategies for each age group and sex, and should guide targeted public health policies.

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