Diabetes duration and cause-specific mortality in the Verona Diabetes Study.

Abstract

OBJECTIVE -To examine the 10-year mortality and effect of diabetes duration on overall and cause-specific mortality in diabetic subjects in the Verona Diabetes Study (VDS).RESEARCH DESIGN AND METHODS -Records from diabetes clinics, family physicians, and a drug consumption database were used to identify 5,818 subjects Ն45 years of age with type 2 diabetes who were alive and residing in Verona, Italy, on 31 December 1986. Vital status of each subject was ascertained on 31 December 1996. Underlying causes of death were determined from death certificates. Death rates and death rate ratios (DRRs) were computed and standardized to the population of Verona in 1991.RESULTS -During the study, 2,328 subjects died; 974 deaths were attributable to cardiovascular disease, 517 to neoplasms, 324 to diabetes-related diseases, 134 to digestive diseases, 250 to other natural causes, and 48 to external causes. There were 81 subjects who died of unknown causes. Death rates from natural causes were higher in men than in women (DRR 1.4, 95% CI 1.2-1.5) and rose in both sexes with increasing duration of diabetes (P = 0.001). Among the natural causes of death, those for diabetes-related diseases were strongly related to diabetes duration (P = 0.001); a modest relationship with duration was also found for ischemic heart disease in men (P = 0.07).CONCLUSIONS -Cardiovascular disease was the principal cause of death among people with type 2 diabetes in the VDS. Rates for natural causes of death rose with increasing duration of diabetes. Deaths from diabetes-related diseases in both sexes and from ischemic heart disease in men were largely responsible for this increase.

Effect of age on the association of non-high-density-lipoprotein cholesterol and apolipoprotein B with cardiovascular mortality in a Mediterranean population with type 2 diabetes: the Casale Monferrato study

“…Furthermore, people with diabetes in this population have lower excess mortality from cardiovascular disease than the general population (standardised mortality ratio 1.42 in the Verona Diabetes Study and 1.35 in the Casale Monferrato Study) [20,21] and are older at onset of the disease, with a median age of 70 years in Italian cohorts of prevalent cases. The Casale Monferrato cohort is representative of Italian patients with diabetes as regards age, sex, duration of disease, BMI and type of antidiabetic treatment [26].…”

“…It would be misleading to generalise the findings to other populations, for a number of reasons. First, both the general populations and people with diabetes living in the Mediterranean region have a lower risk for cardiovascular disease than those living in northern Europe and in the USA [20,21]. Second, there may have been selection bias in forming the cohorts.…”

Impact of diabetes and glycaemic control on peripheral artery disease in Japanese patients with end-stage renal disease: long-term follow-up study from the beginning of haemodialysis

“…On the other hand, diabetes mellitus is considered to contribute to an increase in coronary heart disease [10][11][12]. Patients with diabetes mellitus are also at high risk of death from cardiovascular disease.…”

Age and gender differences in the impact of diabetes on the prevalence of ischemic heart disease: a population-based register study

“…Diabetes is a major public health problem, and the leading cause of death among patients with diabetes is cardiovascular disease (CVD), particularly ischemic heart disease (IHD) and stroke [1][2][3]. It is well known that women are generally at much lower risk of IHD than men.…”