Long-term mortality in a nationwide cohort of childhood-onset type 1 diabetic patients in Norway

Abstract

Aims/hypothesis: We examined long-term total and cause-specific mortality in a nationwide, populationbased Norwegian cohort of patients with childhood-onset type 1 diabetes. Materials and methods: All Norwegian type 1 diabetic patients who were diagnosed between 1973 and 1982 and were under 15 years of age at diagnosis were included (n=1,906). Mortality was recorded from diabetes onset until 31 December 2002 and represented 46,147 person-years. The greatest age attained among deceased subjects was 40 years and the maximum diabetes duration was 30 years. Cause of death was ascertained by reviews of death certificates, autopsy protocols and medical records. The standardised mortality ratio (SMR) was based on national background statistics. Results: During follow-up 103 individuals died. The mortality rate was 2.2/1000 person-years. The overall SMR was 4.0 (95% CI 3.2-4.8) and was similar for males and females. For ischaemic heart disease the SMR was 20.2 (7.3-39.8) for men and 20.6 (1.8-54.1) for women. Acute metabolic complications of diabetes were the most common cause of death under 30 years of age (32%). Cardiovascular disease was responsible for the largest proportion of deaths from the age of 30 years onwards (30%). Violent death accounted for 28% of the deaths in the total cohort (35% among men and 11% among women). Conclusions/interpretation: Childhood-onset type 1 diabetes still carries an increased mortality risk when compared with the general population, particularly for cardiovascular disease. To reduce these deaths, attention should be directed to the prevention of acute metabolic complications, the identification of psychiatric vulnerability and the early detection and treatment of cardiovascular disease and associated risk factors.

Low cumulative incidence of proliferative retinopathy in childhood-onset type 1 diabetes: a 24-year follow-up study

“…Figure 1 illustrates the design of the current study including the number of patients who emigrated and died during follow-up. Mortality and emigration by 1989 and 2001 were assessed by linkage to the official population registry of Norway [22].…”

“…2). Mean age at diagnosis of PDR was 27 years (range: 17-41), and mean diabetes duration was 19 years (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). Thirty-two patients (10.9%) had no retinopathy at follow-up.…”

“…According to medical records, none of them had developed PDR at the time of death, and four of them had NPDR [22].…”

Elevated serum levels of adiponectin in children, adolescents and young adults with type 1 diabetes and the impact of age, gender, body mass index and metabolic control: a longitudinal study

“…There is a two-to eightfold excess risk of coronary artery disease in adults with type 1 diabetes (20)(21)(22). In type 1 diabetes, the relationship between serum adiponectin and the presence of micro-and macrovascular complications is largely unknown.…”

Physical activity in children with type 1 diabetes

“…Por outro lado, a ocorrência de doenças cardiovasculares (DCV) acontece principalmente na idade adulta 12 , e a prevenção do desenvolvimento dessas comorbidades pode ser o maior benefício da prática regular de atividade física (AF).…”