All-cause mortality rates in patients with type 1 diabetes mellitus compared with a non-diabetic population from the UK general practice research database, 1992–1999

Soedamah‐Muthu, Sabita S.; Fuller, John; Mulnier, Henrietta; Raleigh, Veena S; Lawrenson, Ross; Colhoun, Helen M.

doi:10.1007/s00125-005-0120-4

Cited by 202 publications

(150 citation statements)

References 22 publications

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“…Patients with type 2 diabetes were identified using an algorithm based on age at diagnosis and type of treatment. Full details of the cohort selection have been published elsewhere [22][23][24]. For each patient with type 2 diabetes five comparison subjects of the same age and sex and with no record of or treatment for diabetes at any time before 1992 or during the follow-up period were selected at random from the database.…”

Section: Methodsmentioning

confidence: 99%

Risk of stroke in people with type 2 diabetes in the UK: a study using the General Practice Research Database

et al. 2006

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Aims/hypothesis Risk estimates for stroke in patients with diabetes vary. We sought to obtain reliable risk estimates for stroke and the association with diabetes, comorbidity and lifestyle in a large cohort of type 2 diabetic patients in the UK. Materials and methods Using the General Practice Research Database, we identified all patients who had type 2 diabetes and were aged 35 to 89 years on 1 January 1992. We also identified five comparison subjects without diabetes and of the same age and sex. Hazard ratios (HRs) for stroke between January 1992 and October 1999 were calculated, and the association with age, sex, body mass index, smoking, hypertension, atrial fibrillation and duration of diabetes was investigated. Results The absolute rate of stroke was 11.91 per 1,000 person-years (95% CI 11.41-12.43) in people with diabetes (n=41,799) and 5.55 per 1,000 person-years (95% CI 5.40-5.70) in the comparison group (n=202,733). The ageadjusted HR for stroke in type 2 diabetic compared with non-diabetic subjects was 2.19 (95% CI 2.09-2.32) overall, 2.08 (95% CI 1.94-2.24) in men and 2.32 (95% CI 2.16-2.49) in women. The increase in risk attributable to diabetes was highest among young women (HR 8.18; 95% CI 4.31-15.51) and decreased with age. No investigated comorbidity or lifestyle characteristic emerged as a major contributor to risk of stroke. Conclusions/interpretation This study provides risk estimates for stroke for an unselected population from UK general practice. Patients with type 2 diabetes were at an increased risk of stroke, which decreased with age and was higher in women. Additional risk factors for stroke in type 2 diabetic patients included duration of diabetes, smoking, obesity, atrial fibrillation and hypertension.

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Section: Methodsmentioning

confidence: 99%

Risk of stroke in people with type 2 diabetes in the UK: a study using the General Practice Research Database

et al. 2006

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“…Cardiovascular disease has been found to be the main reason for this excess mortality [1][2][3][4]. In an effort to identify easily available and reliable predictors for cardiovascular risk and mortality in diabetes mellitus, the evaluation of parameters reflecting myocardial ventricular repolarisation has been of particular interest.…”

Section: Introductionmentioning

confidence: 99%

QTc interval and resting heart rate as long-term predictors of mortality in type 1 and type 2 diabetes mellitus: a 23-year follow-up

et al. 2006

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Aims/hypothesis We evaluated the association of QT interval corrected for heart rate (QT c ) and resting heart rate (rHR) with mortality (all-causes, cardiovascular, cardiac, and ischaemic heart disease) in subjects with type 1 and type 2 diabetes. Methods We followed 523 diabetic patients (221 with type 1 diabetes, 302 with type 2 diabetes) who were recruited between 1974 and 1977 in Switzerland for the WHO Multinational Study of Vascular Disease in Diabetes. Duration of follow-up was 22.6±0.6 years. Causes of death were obtained from death certificates, hospital records, post-mortem reports, and additional information given by treating physicians.

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“…We subject the resulting initial condition to validation. Each of these stages is also associated with increased mortality rates, mainly due to cardiovascular disease [61][62][63][64]; and these are particularly high for macroalbuminuria [65,66].…”

Section: First Five Yearsmentioning

confidence: 99%

“…So we estimated mortality from diabetes using mortality rates from longitudinal studies [63,65] and prevalence data from Harvey et al [60]. We estimated the presence and degree of severity of complications using the best evidence we could find, including studies conducted in the US or the Netherlands.…”

Section: Datamentioning

confidence: 99%

Requisite models for strategic commissioning: the example of type 1 diabetes

Airoldi¹,

Bevan²,

Morton³

et al. 2008

Health Care Manage Sci

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A developing emphasis of health care reforms has been creating organisations with responsibilities for strategic commissioning of services for defined populations. Such organisations must set priorities in aiming to meet their populations' needs subject to a budget constraint. This requires estimates of the health benefits and costs of different interventions for their populations. This paper outlines a framework that does this and shows how this requires modelling to produce estimates in a way that is transparent to commissioners, of requisite complexity to produce sound estimates for priority setting using routinely available data. The example illustrated in this paper is an intervention that would improve glucose control in the English population with type 1 diabetes. It takes many years for a change in glucose management to deliver maximum benefits; hence the intervention is not good value-for-money in the short run. We aim to give a more strategic view of the costs and benefits modelling costs and benefits in a steady-state model which suggests that the intervention is good value-for-money in the long run.

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All-cause mortality rates in patients with type 1 diabetes mellitus compared with a non-diabetic population from the UK general practice research database, 1992–1999

Cited by 202 publications

References 22 publications

Risk of stroke in people with type 2 diabetes in the UK: a study using the General Practice Research Database

Risk of stroke in people with type 2 diabetes in the UK: a study using the General Practice Research Database

QTc interval and resting heart rate as long-term predictors of mortality in type 1 and type 2 diabetes mellitus: a 23-year follow-up

Requisite models for strategic commissioning: the example of type 1 diabetes

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