Abstract:Estimated life expectancy for patients with type 1 diabetes in Scotland based on data from 2008 through 2010 indicated an estimated loss of life expectancy at age 20 years of approximately 11 years for men and 13 years for women compared with the general population without type 1 diabetes.
“…Interestingly, all‐cause mortality, and the combined outcome (stroke and death), were only slightly increased in type 2 diabetes patients compared to patients without diabetes. Others have demonstrated an increased risk of death in type 1 diabetes patients 27, 28. In a nationwide study, based on data from the Swedish National Diabetes Register, it was found that type 1 diabetes individuals, even at optimal glycemic control, had twice as high a risk of death, predominantly from CVD, compared to matched controls from the general population 27.…”
BackgroundWe performed a nationwide population‐based cohort study to investigate the long‐term risk of stroke after coronary artery bypass grafting in patients with type 1 and type 2 diabetes.Methods and ResultsAll patients who underwent primary coronary artery bypass grafting in Sweden from 2000 through 2011 were included from the SWEDEHEART register. We excluded patients with prior stroke, and patients who had a stroke or died within 30 days of surgery. The National Diabetes Register was used to identify patients with type 1 and type 2 diabetes. Incident stroke (ischemic and hemorrhagic), and all‐cause mortality was obtained by record linkage with the National Patient Register and the Cause of Death register. We used multivariable Cox regression to estimate the risk of stroke in relation to type of diabetes. A total of 53 820 patients (type 1 diabetes [n=714], type 2 diabetes [n=10 054], no diabetes [n=43 052]) were included. During a mean follow‐up of 7.4 years (398 337 person‐years), in total, 8.0% (n=4296) of the patients had a stroke: 7.3% (n=52) in patients with type 1 diabetes, 9.1% (n=915) in patients with type 2 diabetes, and 7.7% (n=3329) in patients with no diabetes. The multivariable adjusted hazard ratio (95% CI) for all stroke was 1.59 (1.20–2.11) in type 1 diabetes, and 1.32 (1.23–1.43) in type 2 diabetes.ConclusionsThe long‐term risk for stroke after coronary artery bypass grafting was increased in patients with type 1 and type 2 diabetes, compared to patients with no diabetes.
“…Interestingly, all‐cause mortality, and the combined outcome (stroke and death), were only slightly increased in type 2 diabetes patients compared to patients without diabetes. Others have demonstrated an increased risk of death in type 1 diabetes patients 27, 28. In a nationwide study, based on data from the Swedish National Diabetes Register, it was found that type 1 diabetes individuals, even at optimal glycemic control, had twice as high a risk of death, predominantly from CVD, compared to matched controls from the general population 27.…”
BackgroundWe performed a nationwide population‐based cohort study to investigate the long‐term risk of stroke after coronary artery bypass grafting in patients with type 1 and type 2 diabetes.Methods and ResultsAll patients who underwent primary coronary artery bypass grafting in Sweden from 2000 through 2011 were included from the SWEDEHEART register. We excluded patients with prior stroke, and patients who had a stroke or died within 30 days of surgery. The National Diabetes Register was used to identify patients with type 1 and type 2 diabetes. Incident stroke (ischemic and hemorrhagic), and all‐cause mortality was obtained by record linkage with the National Patient Register and the Cause of Death register. We used multivariable Cox regression to estimate the risk of stroke in relation to type of diabetes. A total of 53 820 patients (type 1 diabetes [n=714], type 2 diabetes [n=10 054], no diabetes [n=43 052]) were included. During a mean follow‐up of 7.4 years (398 337 person‐years), in total, 8.0% (n=4296) of the patients had a stroke: 7.3% (n=52) in patients with type 1 diabetes, 9.1% (n=915) in patients with type 2 diabetes, and 7.7% (n=3329) in patients with no diabetes. The multivariable adjusted hazard ratio (95% CI) for all stroke was 1.59 (1.20–2.11) in type 1 diabetes, and 1.32 (1.23–1.43) in type 2 diabetes.ConclusionsThe long‐term risk for stroke after coronary artery bypass grafting was increased in patients with type 1 and type 2 diabetes, compared to patients with no diabetes.
“…3 T1DM can occur at any age, but is usually diagnosed in children and adolescents 1 and its incidence has been rising steadily in developed countries since the 1950s. 4 It is caused by the absolute lack of insulin production due to autoimmune destruction of the insulin-producing beta cells of the pancreas.…”
Insulin is a required therapy for people with type 1 diabetes, and its use in the treatment of type 2 diabetes has been increasing in recent years. This article discusses the main types of insulin currently available, their properties and their role in the management of both type 1 and type 2 diabetes.
“…A newly published systematic review assessing mortality in type 1 diabetes documented less marked excess mortality in more recent studies [19]. A recent Scottish study estimated a lower life expectancy compared with that of the general population [20]. Long-term follow-up of patients with type 1 diabetes in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) showed a modestly lower mortality rate in those initially receiving intensive therapy compared with those receiving conventional therapy [21], and a Swedish register study reported that the risk of mortality increased with increasing HbA 1c [22].…”
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).
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