Early mortality in EURODIAB population-based cohorts of type 1 diabetes diagnosed in childhood since 1989

Patterson, Christopher; Dahlquist, Gisela; Harjutsalo, Valma; Joner, Geir; Feltbower, RG; Svensson, Jannet; Schober, Edith; Gyürüs, Éva; Castell, Conxa; Urbonaite, Brone; Rosenbauer, Joachim; Iotova, Violeta; Þórsson, Árni V.; Soltész, Gyula

doi:10.1007/s00125-007-0824-8

Cited by 180 publications

(122 citation statements)

References 8 publications

Supporting

Mentioning

111

Contrasting

Unclassified

Order By: Relevance

“…Several studies have found that the association between diabetes and mortality differs between different ethnic groups, and therefore our results are probably applicable only to similar ethnic populations [8,9]. Aside from this, the association between diabetes and mortality is most likely to be dependent on the healthcare system and the diagnosis and treatment options for diabetes, because early diagnosed and well-regulated diabetes is not as harmful as late diagnosed and poorly regulated diabetes [38].…”

Section: Discussionmentioning

confidence: 89%

See 1 more Smart Citation

Causes of death among diabetic patients in Denmark

2011

View full text Add to dashboard Cite

Aims/hypothesis To study the distribution of causes of death in the Danish population, and its variation by diabetes status, sex, age and calendar year as well as the years of life lost from the specific causes of death. Methods Persons aged 30-98 years were followed from 1995 to 2008 by linkage of Danish registers. Poisson regression was used to model cause-specific mortality rates by age and calendar time for each specific cause of death, according to sex and diabetes status. The mortality rates were also modelled as a function of age and birth cohort. We computed the distribution of causes of death and years of life lost from specific causes of death due to diabetes. Results During the 14-year study period, patients with diabetes contributed 2.3 million person-years of follow-up and 124,210 deaths, whereas persons without diabetes contributed 45.1 million person-years and 648,020 deaths. The mortality was higher among individuals with diabetes, and the mortality ratio (diabetes vs no diabetes) decreased with age and for all causes and cardiovascular diseases also by calendar time. The effect of sex on the association between diabetes and mortality varied with age and cause of death. About 9 years of life were lost to diabetes at age 30 years, and 3 years at age 70 years. Conclusions/interpretation Age-specific mortality is higher among people with diabetes, and rate ratios vary with age, sex, calendar period and cause of death. The distribution of causes of death was similar for persons with and without diabetes.

show abstract

Section: Discussionmentioning

confidence: 89%

“…Other previous studies have found that the association between diabetes and mortality varies across countries [8,9]. Only one Danish study exists, in which the association between diabetes and cause-specific mortality has been studied [10].…”

Section: Introductionmentioning

confidence: 99%

Causes of death among diabetic patients in Denmark

2011

View full text Add to dashboard Cite

show abstract

“…Despite advances in treatment, type 1 diabetes is still associated with a considerable risk of premature mortality, resulting from both acute and chronic complications [1][2][3][4][5][6]. Mortality varies markedly between countries, and there are indications that countries with a lower incidence of type 1 diabetes have higher absolute and relative mortality compared with high incidence countries [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

All-cause mortality in a nationwide cohort of childhood-onset diabetes in Norway 1973–2013

et al. 2015

View full text Add to dashboard Cite

Aims/hypothesis The aim of this study was to assess the association between all-cause mortality and sex, age at diagnosis and year of diagnosis in Norwegian patients with childhoodonset diabetes. Methods The study was based on the nationwide, populationbased Norwegian Childhood Diabetes Registry, which includes all newly diagnosed cases of childhood-onset diabetes at age 0-14 years in 1973-1982 and 1989-2012 (n=7,884). Patients were followed until date of death, emigration or 30 September 2013. Results Among the 7,884 patients, representing 132,420 person-years, 249 (3.2%) died during a mean follow-up of 16.8 (range 0.0-40.7) years. The standardised mortality ratio (SMR) for the total cohort was 3.6 (95% CI 3.1, 4.0), increasing by attained age. Absolute mortality was significantly lower in females than in males (HR 0.50 [95% CI 0.38, 0.65]), although the SMRs were similar. Cox regression analysis showed a significant decrease in mortality of 49% (HR 0.51 [95% CI 0.28, 0.93]) for those diagnosed in 1999-2012 compared with those diagnosed in 1973-1982 (p=0.03). Conclusions/interpretation In spite of improved diabetes care, mortality is still three to four times higher in those with childhood-onset diabetes compared with the general population in Norway. However, absolute mortality has declined among children diagnosed most recently (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012) compared with those diagnosed in the earliest period (1973)(1974)(1975)(1976)(1977)(1978)(1979)(1980)(1981)(1982).

show abstract

“…In a review by , estimates of 4%, 7%, and 27% were reported. Patterson et al (2007) reported an estimate of 9% (of 134 deaths, 5 were due to hypoglycaemia and 7 were dead in the bed; 12/134 = 9%). The average of these reported values was 12%.…”

Section: Limited Joint Mobilitymentioning

confidence: 99%

Development and validation of a cost–utility model for Type 1 diabetes mellitus

et al. 2015

View full text Add to dashboard Cite

A simple cost-utility model was developed to evaluate new interventions for Type 1 diabetes mellitus by assessing the association between the interventions' effects on mean glycated haemoglobin and long-term complications and the risk of hypoglycaemic events. High-quality, recently reported data specific to people with Type 1 diabetes mellitus were identified by a systematic review. Methods: Through a systematic review, we identified complications associated with Type 1 DM and data describing the long-term incidence of these complications. An individual patient simulation model was developed and included the following complications: cardiovascular disease, peripheral neuropathy, microalbuminuria, end-stage renal disease, proliferative retinopathy, ketoacidosis, cataract, and adverse birth outcomes. Risk equations were developed from published cumulative incidence data and hazard ratios for the effect of glycated haemoglobin, age, and duration of diabetes. We validated the model by comparing model predictions with observed outcomes from studies used to build the model (internal validation) and from other published data (external validation). We performed illustrative analyses for typical patient cohorts and a hypothetical intervention.Results: Model predictions were within 2% of expected values in the internal validation and within 8% of observed values in the external validation (percentages represent absolute differences in the cumulative incidence). Conclusions:The model utilised high-quality, recent data specific to people with Type 1 DM. In the model validation, results deviated less than 8% from expected values.

show abstract

Early mortality in EURODIAB population-based cohorts of type 1 diabetes diagnosed in childhood since 1989

Abstract: Before the onset of late complications, significant excess mortality existed following the diagnosis of type 1 diabetes in childhood, even in recent years. Variation between countries in this excess could not be explained.

Cited by 180 publications

References 8 publications

Causes of death among diabetic patients in Denmark

Causes of death among diabetic patients in Denmark

All-cause mortality in a nationwide cohort of childhood-onset diabetes in Norway 1973–2013

Development and validation of a cost–utility model for Type 1 diabetes mellitus

Contact Info

Product

Resources

About