Increased Mortality Risk in People with Type 2 Diabetes Mellitus in Lithuania

Abstract

This retrospective cohort study aimed to analyze overall and cause-specific mortality risk in people with type 2 diabetes mellitus (T2DM) in Lithuania. Information on the diagnosis of T2DM and glucose-lowering medication was obtained from the National Health Insurance Fund database, causes of death–from death certificates. Sex, age, and calendar period-standardized mortality ratios (SMRs) were calculated. In addition, 89,512 patients were followed-up between 2010 and 2017, contributing to the observation period of 592,321 person-years. Overall mortality risk was increased for both sexes (overall SMR = 1.35, 95% confidence interval (CI) 1.34–1.37). Greatest mortality risk was in the age group of 40–49 years at diabetes diagnosis (SMR = 1.68, 95% CI 1.60–1.76) and among those who had died before the age of 50 (SMR = 22.04, 95% CI 18.82–25.81). Patients treated with insulin only had the highest SMR (2.43, 95% CI 2.32–2.55). Mortality risk increased with increasing diabetes duration and was higher in women in all these groups. The highest cause-specific SMRs were infection-related causes (SMR = 1.44), particularly septicemia (SMR = 1.78), diseases of the circulatory system (SMR = 1.42), especially ischemic heart (SMR = 1.46) and cerebrovascular diseases (SMR = 1.38), as well as diseases of the digestive system (SMR = 1.35). Cancer mortality risk was elevated for women (SMR = 1.13), but not for men (SMR = 0.93). In conclusion, people with T2DM had an excess mortality risk, which was higher in women compared to men, younger people, in those who were diagnosed with T2DM at a younger age, had longer diabetes duration, and who required treatment with insulin.

Gamma‐glutamyl transferase and the risk of all‐cause and disease‐specific mortality in patients with diabetes: A nationwide cohort study

“…The cause of death was identified as follows using the Korean Standard Classification of Diseases and Causes of Death in accordance with the following ICD-10 codes: CVD (I00-99), including ischemic heart disease (I20-25) and ischemic stroke (I63-64); cancer (C00-97), excluding hepatocellular carcinoma (C22); liver disease (C22, K70-76); respiratory disease (J00-99); infectious disease (A00-B99); and T2DM (E11-14). 25,26 2.5 | Covariates BMI was calculated as weight (kg) divided by height squared (m 2 ). Lifestyle habits were assessed using a selfreported questionnaire.…”

“…Data on the date and cause of death, which were linked to the NHIS database, were provided by Statistics Korea based on death certificates. The cause of death was identified as follows using the Korean Standard Classification of Diseases and Causes of Death in accordance with the following ICD‐10 codes: CVD (I00–99), including ischemic heart disease (I20–25) and ischemic stroke (I63–64); cancer (C00–97), excluding hepatocellular carcinoma (C22); liver disease (C22, K70–76); respiratory disease (J00–99); infectious disease (A00‐B99); and T2DM (E11–14) 25,26 …”

Nursing-Intense Health Education Intervention for Persons with Type 2 Diabetes: A Quasi-Experimental Study

“…It has been estimated that for every 1% by which HbA1c is reduced in patients with poorly controlled DM2, the probability of premature death falls by 21% and that of microvascular complications by 37%. The duration of DM2 is also associated with premature death from cardiovascular disease [34][35][36].…”

Machine learning-based prediction of diabetes risk by combining exposome and electrocardiographic predictors

“…2 Therefore, in recent years, there has been a shift from a focus on diagnosis to an increased interest in risk prediction. 3 Existing risk models for diabetes have limited accuracy as the predictive models have been based on generic risk factors such as obesity, age, and lifestyle. 4 Hence, they do not include more precise predictors that describe patient-specific health patterns.…”