Diabetes, mortality and coronary heart disease in the prospective Dubbo study of Australian elderly

La, Simons; McCallum, John; Friedlander, Yechiel; Simons, Judith

doi:10.1111/j.1445-5994.1996.tb02909.x

Cited by 31 publications

(19 citation statements)

References 30 publications

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“…A common criterion for the diagnosis was if subjects had previously been diagnosed by a physician as having diabetes, or had a history of treatment with insulin or oral hypoglycemic agents. Five studies used random or fasting glucose parameters as alternative diagnostic criteria, but they did not report how often these criteria were used (8,10,13,27,28). The proportion of participants who actually had glucose measurements taken was reported in only one study (8).…”

Section: Discussionmentioning

confidence: 99%

“…RESULTS -Sixteen prospective cohort studies were eligible for this analysis (5,6,(8)(9)(10)13,18,(21)(22)(23)(24)(25)(26)(27)(28)(29); 5 studies, as described above, were excluded from further consideration because of missing data. Important characteristics of all of the studies are listed in Tables 1 and 2.…”

Section: Discussionmentioning

confidence: 99%

“…An earlier meta-analysis (7) attempted to address this question, concluding that diabetes did reduce the sex differential in coronary heart disease (CHD) mortality. However, the analysis was limited to literature known to the author and did not include 3 recent large studies (8)(9)(10).…”

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confidence: 99%

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Impact of diabetes on coronary artery disease in women and men: a meta-analysis of prospective studies.

et al. 2000

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A meta-analysis of prospective studies O R I G I N A L A R T I C L EOBJECTIVE -Women are at a much lower risk of coronary disease mortality than men are. It is widely believed that diabetes "erases" this female advantage, increasing the risk of heart disease much more in women than in men. In reality, the extent of this increased risk is controversial, with studies showing conflicting results and wide confidence intervals. Clarification of this issue has implications for the pathogenesis of coronary disease, and for public health efforts to reduce coronary disease in women.RESEARCH DESIGN AND METHODS -We performed a meta-analysis to calculate a summary estimate of the relative risk of coronary death among women with diabetes as compared to those without. For comparison, we also calculated the analogous risk among men. All prospective cohort studies containing both men and women, and both patients with and without diabetes, were examined. Sixteen studies were identified; 10 had sufficient data for statistical analysis.RESULTS -After combining studies that adjusted for other cardiac risk factors, the relative risk of coronary death from diabetes was 2.58 (95% CI 2.05-3.26) for women and 1.85 (1.47-2.33) for men. This difference is statistically significant (P = 0.045). Other sensitivity analyses did not change these estimates appreciably.CONCLUSIONS -The impact of diabetes on the risk of coronary death is significantly greater for women than men. Further research is required to explain this clinically meaningful difference between the sexes. Diabetes Care 23:962-968, 2000

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of diabetes on coronary artery disease in women and men: a meta-analysis of prospective studies.

et al. 2000

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“…In a Western Australian study (13), determination of death rates for type 1 diabetic individuals was not feasible because of the small number of events in this subject group. Diabetes was found to be a significant predictor of all-cause mortality and coronary heart disease in an elderly Australian community, but again, this study focused on type 2 diabetes (14). In New Zealand, Scragg (15) reported secular trends in mortality (1966)(1967)(1968)(1969)(1970)(1971)(1972)(1973)(1974)(1975)(1976)(1977)(1978)(1979)(1980)(1981)(1982)(1983)(1984)(1985), but no distinction was made for type of diabetes, and cases were enumerated through death certificates, which is problematic (16).…”

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confidence: 99%

All-Cause Mortality in the Canterbury (New Zealand) Insulin-Treated Diabetic Registry Population

2001

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RESEARCH DESIGN AND METHODS -Insulin-treated diabetic subjects (n = 1,008) on the Canterbury Diabetes Registry were tracked over 9 years, and their vital status was determined. Death rates were standardized using direct and indirect methods. Cox proportional hazard regression was used to model the effects of demographic and clinical covariates on survival time.RESULTS -At study entry, age ranged from 2.9 to 92.7 years, with mean 48.7 ± 20.4 years; age at diagnosis was 0.2-88.9 years, mean 34.5 ± 20.0 years; and duration of diabetes was 0.1-58.5 years, mean 14.0 ± 10.6 years. There were 303 deaths in 7,372 person-years of follow-up with a standardized mortality ratio (SMR) of 2.6 (95% CI 2.4-3.0). Relative mortality was greatest for those aged 30-39 years .2]). The death rate for the diabetic cohort standardized against the Segi world standard population was 16.2 per 1,000. Attained age, sex, and clinical subtype were significant predictors of mortality. The SMR for subjects with type 1 diabetes and age at onset Ͻ30 years was 3.7 (CI 2.7-5.0), 2.2 (1.8-2.6) for those with onset Ն30 years, and 3.1 (2.5-3.7) for subjects suspected of having latent autoimmune diabetes in adulthood or insulin-treated type 2 diabetes. Life expectancy was reduced for both sexes at all ages.CONCLUSIONS -Mortality rates for insulin-treated diabetic individuals remain high, resulting in shortened life spans relative to the general population. Marked differences in mortality exist between clinical groups of subjects. Further research is needed to improve diabetes classification and to clarify differences in health outcomes.

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“…The relative risks were obtained from published epidemiological studies. [186][187][188][189][190] The mortality risk associated with IGT in the model by Caro and colleagues 173 was obtained by adjusting age-and sex-dependent mortality estimates from Canadian life tables. Mortality risks from the life tables were increased by 45% based on the findings of an epidemiological study.…”

Section: Mortalitymentioning

confidence: 99%

Screening for type 2 diabetes: literature review and economic modelling

2007

Clinical Governance: An International Journal

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Diabetes, mortality and coronary heart disease in the prospective Dubbo study of Australian elderly

Abstract: The vascular disease burden of diabetes in the elderly has been confirmed, especially in women. A number of conventional risk factors are contributing to this burden and may be amenable to treatment.

Cited by 31 publications

References 30 publications

Impact of diabetes on coronary artery disease in women and men: a meta-analysis of prospective studies.

Impact of diabetes on coronary artery disease in women and men: a meta-analysis of prospective studies.

All-Cause Mortality in the Canterbury (New Zealand) Insulin-Treated Diabetic Registry Population

Screening for type 2 diabetes: literature review and economic modelling

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