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). MATERIALS AND 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.
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). MATERIALS AND 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.
Authors: B Littorin; G Sundkvist; W Hagopian; M Landin-Olsson; A Lernmark; J Ostman; H J Arnqvist; G Blohmé; J Bolinder; J W Eriksson; F Lithner; B Scherstén; L Wibell Journal: Diabetes Care Date: 1999-03 Impact factor: 19.112
Authors: L Wibell; L Nyström; J Ostman; H Arnqvist; G Blohmé; F Lithner; B Littorin; G Sundkvist Journal: J Intern Med Date: 2001-03 Impact factor: 8.989
Authors: L Nyström; G Dahlquist; J Ostman; S Wall; H Arnqvist; G Blohmé; F Lithner; B Littorin; B Scherstén; L Wibell Journal: Int J Epidemiol Date: 1992-04 Impact factor: 7.196
Authors: Georgiana-Aura Giurgea; Katrin Nagl; Michael Gschwandtner; Clemens Höbaus; Thomas Hörtenhuber; Renate Koppensteiner; Christian Margeta; Maria Fritsch; Birgit Rami-Merhar; Gerit-Holger Schernthaner; Oliver Schlager; Edith Schober; Sabine Steiner; Andrea Willfort-Ehringer Journal: Wien Klin Wochenschr Date: 2014-11-21 Impact factor: 1.704
Authors: C Stettler; A Bearth; S Allemann; M Zwahlen; L Zanchin; M Deplazes; E R Christ; A Teuscher; P Diem Journal: Diabetologia Date: 2006-11-10 Impact factor: 10.122
Authors: W Susan Cheng; Deborah L Wingard; Donna Kritz-Silverstein; Elizabeth Barrett-Connor Journal: Diabetes Care Date: 2007-10-24 Impact factor: 19.112
Authors: Aaron M Secrest; Dorothy J Becker; Sheryl F Kelsey; Ronald E LaPorte; Trevor J Orchard Journal: Diabetes Care Date: 2010-12 Impact factor: 19.112