Diabetes has a harder-than-expected impact on young adults who have difficulty controlling their blood sugar and who are more often in hospital care than older adults with chronic disease.

The discovery, reported Monday by the Minnesota Department of Health, did not surprise doctors who work daily with young or elderly patients, but suggests that health officials may need to rethink diabetes support programs of the state, which tend to target people aged 45 or older.

"We need to adapt our care and action to meet the needs of young adults with diabetes," said Jan Malcolm, Commissioner for Health. "These people have a long life ahead of them and it is important to ensure that diabetes is well managed so that they can live these years in good health."

Adults under 44 represent only 16% of Minnesota's diabetic population. However, a study by researchers from the Department of Health and the University of Minnesota found that they were almost three times as likely as adults aged 45 to 64 to need hospitalization for their disease and four times as likely as those aged 65 and over.

The US Centers for Disease Control and Prevention reported on the findings in Preventing Chronic Disease.

Diabetes occurs when the body does not produce or respond to insulin, a hormone involved in the metabolism and regulation of blood sugar. This is one of the leading causes of stroke, heart and kidney disease as well as eye and circulatory problems.

The study included people with type 1 diabetes, whose body develops little or no insulin and is often diagnosed in childhood, as well as people with type 2 diabetes , whose body becomes resistant to insulin over time.

This could have tipped the scales in favor of the youngest, because type 1 diabetes is often found in younger age groups and is more difficult to manage. But all young adults participating in the study have struggled to achieve blood glucose goals; only 25.4% of those of type 1 respected recommended levels, compared to 46.3% of type 2.

"None of them is meeting its goals," said Renee Kidney, lead author of the study.

Two decades ago, type 2 diabetes was rarely diagnosed in young adults and children. But it has emerged as a serious health problem because of its connection to the rising rate of obesity in the United States. Research has shown that this disease is more serious in young adults and requires them to inject synthetic insulin earlier than those who develop the disease at a later age.

Diabetes can also be more difficult to manage for young adults, who lead a less predictable life when they find a career, change jobs, meet their spouse and have children, Kidney said.

The study reveals that young adults with diabetes are also more likely to smoke, which can exacerbate symptoms and suffer from depression.

Young adults might experience the desperation of having been diagnosed with chronic illness and the guilt of not having "managed" diabetes, said Dr. Amy Criego, Park Nicollet's endocrinologist, not involved in the disease. study.

"It's very easy for young people to feel judged by the labels that are given to them when it comes to managing their diabetes," she said.

The rising cost of insulin could also be a bigger problem for young adults because they have less access to health insurance than older people, she added.

Criego was optimistic. The study was based on recordings of clinics and surveys from 2015 and earlier. Portable automatic insulin pumps have become increasingly common since then, as have diabetes applications for phones and watches.

"Glucose management is more difficult in this age group, because of the lack of structure of their environments and their lifestyles," she said, "but they are also more comfortable with technology. So, that balances maybe. "