The Sugar That Speaks: Early Metabolic Signals Predicting Cardiovascular Events in Young Adults with Type 2 Diabetes

Asim Ahmed¹, Abla Almalik², Hugo Moreau³, Claire Bernard⁴

Abstract

Cardiovascular disease remains the leading cause of mortality among patients with type 2 diabetes. However, early metabolic predictors of cardiovascular events among young adults with diabetes remain poorly characterized. This prospective cohort study evaluated metabolic biomarkers associated with early cardiovascular risk among adults aged 25–45 years with type 2 diabetes.

A total of 1,086 patients were enrolled from three tertiary hospitals between 2021 and 2024. Participants were followed for 36 months. Clinical parameters including HbA1c, triglycerides, LDL cholesterol, inflammatory markers, and insulin resistance indices were analyzed.

During follow-up, 14.3% of participants developed cardiovascular events, including myocardial infarction, unstable angina, or ischemic stroke. Patients with HbA1c ≥8.5% had a 2.8-fold increased risk of cardiovascular events (95% CI: 1.9–4.2). Elevated triglyceride levels above 200 mg/dL were associated with 2.1-fold increased risk.

Multivariate analysis identified insulin resistance index, systemic inflammation (CRP), and triglyceride levels as the strongest predictors of early cardiovascular complications. Patients with combined metabolic risk factors had a threefold higher probability of cardiovascular events.

These findings highlight the importance of aggressive metabolic control in young adults with diabetes and support early cardiovascular risk stratification strategies in clinical practice.