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Excess mortality in incident cases of diabetes mellitus aged 15 to 34 years at diagnosis: a population-based study (DISS) in Sweden

Waernbaum, I ; Blohme, G ; Ostman, J ; Sundkvist, Göran LU ; Eriksson, JW ; Arnqvist, HJ ; Bolinder, J and Nystrom, L (2006) In Diabetologia 49(4). p.653-659
Abstract
Aims/hypothesis: The objective of the study was to analyse the mortality, survival and cause of death patterns in incident cases of diabetes in the 15-34-year age group that were reported to the nationwide prospective Diabetes Incidence Study in Sweden (DISS). Methods: During the study period 1983-1999, 6,771 incident cases were reported. Identification of deaths was made by linking the records to the nationwide Cause of Death Register. Results: With an average follow-up of 8.5 years, resulting in 59,231 person-years, 159 deaths were identified. Diabetes was reported as the underlying cause of death in 51 patients (32%), and as a contributing cause of death in another 42 patients (26%). The standardised mortality ratio (SMR) was... (More)
Aims/hypothesis: The objective of the study was to analyse the mortality, survival and cause of death patterns in incident cases of diabetes in the 15-34-year age group that were reported to the nationwide prospective Diabetes Incidence Study in Sweden (DISS). Methods: During the study period 1983-1999, 6,771 incident cases were reported. Identification of deaths was made by linking the records to the nationwide Cause of Death Register. Results: With an average follow-up of 8.5 years, resulting in 59,231 person-years, 159 deaths were identified. Diabetes was reported as the underlying cause of death in 51 patients (32%), and as a contributing cause of death in another 42 patients (26%). The standardised mortality ratio (SMR) was significantly elevated (RR=2.4; 95% CI: 2.0-2.8). The SMR was higher for patients classified by the reporting physician as having type 2 diabetes at diagnosis than for those classified as type 1 diabetic (2.9 and 1.8, respectively). Survival analysis showed significant differences in survival curves between males and females (p=0.0003) as well as between cases with different types of diabetes (p=0.005). This pattern was also reflected in the Cox regression model showing significantly increased hazard for males vs females (p=0.0002), and for type 2 vs type 1 (p=0.015) when controlling for age. Conclusions/interpretation: This study shows a two-fold excess mortality in patients with type 1 diabetes and a three-fold excess mortality in patients with type 2 diabetes. Thus, despite advances in treatment, diabetes still carries an increased mortality in young adults, even in a country with a good economic and educational patient status and easy access to health care. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
type 2 diabetes, type 1 diabetes, mortality, cause of death, cohort
in
Diabetologia
volume
49
issue
4
pages
653 - 659
publisher
Springer
external identifiers
  • wos:000235900100007
  • pmid:16447054
  • scopus:33644826995
ISSN
1432-0428
DOI
10.1007/s00125-005-0135-x
language
English
LU publication?
yes
id
d1a4b564-1b91-4b76-b805-25f111546861 (old id 693540)
date added to LUP
2016-04-01 12:34:38
date last changed
2020-01-12 10:05:22
@article{d1a4b564-1b91-4b76-b805-25f111546861,
  abstract     = {Aims/hypothesis: The objective of the study was to analyse the mortality, survival and cause of death patterns in incident cases of diabetes in the 15-34-year age group that were reported to the nationwide prospective Diabetes Incidence Study in Sweden (DISS). Methods: During the study period 1983-1999, 6,771 incident cases were reported. Identification of deaths was made by linking the records to the nationwide Cause of Death Register. Results: With an average follow-up of 8.5 years, resulting in 59,231 person-years, 159 deaths were identified. Diabetes was reported as the underlying cause of death in 51 patients (32%), and as a contributing cause of death in another 42 patients (26%). The standardised mortality ratio (SMR) was significantly elevated (RR=2.4; 95% CI: 2.0-2.8). The SMR was higher for patients classified by the reporting physician as having type 2 diabetes at diagnosis than for those classified as type 1 diabetic (2.9 and 1.8, respectively). Survival analysis showed significant differences in survival curves between males and females (p=0.0003) as well as between cases with different types of diabetes (p=0.005). This pattern was also reflected in the Cox regression model showing significantly increased hazard for males vs females (p=0.0002), and for type 2 vs type 1 (p=0.015) when controlling for age. Conclusions/interpretation: This study shows a two-fold excess mortality in patients with type 1 diabetes and a three-fold excess mortality in patients with type 2 diabetes. Thus, despite advances in treatment, diabetes still carries an increased mortality in young adults, even in a country with a good economic and educational patient status and easy access to health care.},
  author       = {Waernbaum, I and Blohme, G and Ostman, J and Sundkvist, Göran and Eriksson, JW and Arnqvist, HJ and Bolinder, J and Nystrom, L},
  issn         = {1432-0428},
  language     = {eng},
  number       = {4},
  pages        = {653--659},
  publisher    = {Springer},
  series       = {Diabetologia},
  title        = {Excess mortality in incident cases of diabetes mellitus aged 15 to 34 years at diagnosis: a population-based study (DISS) in Sweden},
  url          = {http://dx.doi.org/10.1007/s00125-005-0135-x},
  doi          = {10.1007/s00125-005-0135-x},
  volume       = {49},
  year         = {2006},
}