Markedly increased renal disease mortality and incidence of renal replacement therapy among IDDM patients in Japan in contrast to Allegheny County, Pennsylvania, USA

Matsushima, Masato; Tajima, Naoko; Re, LaPorte; Orchard, Trevor J.; Es, Tull; If, Gower; Kitagawa, Teruo

doi:10.1007/bf00400100

Cited by 29 publications

(15 citation statements)

References 20 publications

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“…This suggests, not that the early ages of onset are protective but rather that "the clock does not run as fast" for the years before pubertal onset. A similar impact of age at onset has been indicated in a population-based study in an American and a Japanese cohort where a positive correlation between age at onset and risk of ESRD was found (35). Other studies have indicated that the prepubertal years with diabetes involve a reduced risk or a longer time to development of diabetic nephropathy and other microvascular complications, e.g., retinopathy (6,9,11,36 -38).…”

Section: Resultssupporting

confidence: 66%

Age at Onset of Childhood-Onset Type 1 Diabetes and the Development of End-Stage Renal Disease

et al. 2006

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OBJECTIVE -To analyze the impact of age at onset on the development of end-stage renal disease (ESRD) due to diabetic nephropathy in a nationwide population-based cohort with childhood-onset type 1 diabetes. RESEARCH DESIGN AND METHODS-A record linkage between two nationwide registers, the Swedish Childhood Diabetes Registry, including 12,032 cases with childhoodonset diabetes, and the Swedish Registry for Active Treatment of Uraemia was performed. Log-rank test was used to test differences between cumulative risk curves of developing ESRD due to diabetic nephropathy in three different strata of age at onset (0 -4, 5-9, and 10 -14 years).RESULTS -At a maximum follow-up of 27 years, 33 patients had developed ESRD due to diabetic nephropathy and all had a diabetes duration Ͼ15 years. In total, 4,414 patients had diabetes duration Ͼ15 years, and thus the risk in this cohort to develop ESRD was 33 of 4,414 (0.7%). A significant difference in risk of developing ESRD was found between the youngest (0 -4 years) and the two older (5-9 and 10 -14 years) age-at-onset strata (P ϭ 0.03 and P ϭ 0.001, respectively). A significant difference in the risk of developing ESRD was also found between children with prepubertal (0 -4 and 5-9 years, n ϭ 2,424) and pubertal (10 -14 years, n ϭ 2000) onset of diabetes (P ϭ 0.002). No patient with onset of diabetes before 5 years of age had developed ESRD.CONCLUSIONS -With a median duration of 21 years in this population-based Swedish cohort with childhood-onset diabetes, Ͻ1% of the patients had developed ESRD due to diabetic nephropathy, and a prepubertal onset of diabetes seems to prolong the time to development of ESRD.

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Section: Resultssupporting

confidence: 66%

Age at Onset of Childhood-Onset Type 1 Diabetes and the Development of End-Stage Renal Disease

et al. 2006

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“…In addition, there may be misclassified causes of death [45], with renaldisease-related deaths misclassified as CVD or vice versa [13]. The Swedish renal mortality rates reported here are lower than those previously seen in a younger Japanese and US cohort where an expert committee based the cause of death classification on information from the attending physician or death certificates [14,[46][47][48]. However, the rates of end stage renal disease (ESRD) for those with type 1 diabetes in Sweden have previously been found to be low [49].…”

Section: Discussionmentioning

confidence: 52%

Recent trends in life expectancy for people with type 1 diabetes in Sweden

et al. 2016

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“…The next step involves examining complementary data to understand the immediate causes of death driving the differences and links to possible underlying organizational and system weaknesses or failures. Thus, much of the excess mortality in Japan was found to be due to diabetic renal disease (22), largely caused by higher incidence of end-stage renal disease and reduced access to dialysis compared with the U.S. (23). Lower survival rates among those with type 1 diabetes in Estonia and Latvia compared with Finland are explained by a higher proportion of deaths due to acute complications of diabetes (24), reflecting, among others, the greater experience in Finland where type 1 diabetes is much more common than in the Baltic states.…”

Section: Results -mentioning

confidence: 99%

Diabetes as a Tracer Condition in International Benchmarking of Health Systems

2006

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OBJECTIVE -To assess the performance of health systems using diabetes as a tracer condition.RESEARCH DESIGN AND METHODS -We generated a measure of "case-fatality" among young people with diabetes using the mortality-to-incidence ratio (M/I ratio) for 29 industrialized countries using published data on diabetes incidence and mortality. Standardized incidence rates for ages 0 -14 years were extracted from the World Health Organization DiaMond study for the period 1990 -1994; data on death from diabetes for ages 0 -39 years were obtained from the World Health Organization mortality database and converted into agestandardized death rates for the period 1994 -1998, using the European standard population.RESULTS -The M/I ratio varied Ͼ10-fold. These relative differences appear similar to those observed in cohort studies of mortality among young people with type 1 diabetes in five countries. A sensitivity analysis showed that using plausible assumptions about potential overestimation of diabetes as a cause of death and underestimation of incidence rates in the U.S. yields an M/I ratio that would still be twice as high as in the U.K. or Canada.CONCLUSIONS -The M/I ratio for diabetes provides a means of differentiating countries on quality of care for people with diabetes. It is solely an indicator of potential problems, a basis for stimulating more detailed assessments of whether such problems exist, and what can be done to address them. Diabetes Care 29:1007-1011, 2006D esigning simple, practical, and understandable ways to assess health system performance remains a challenging aspiration. Recognizing the multifunctional complexity of a health system, existing frameworks use a range of indicators to capture the different aspects of health systems (1). However, many of these indicators have no obvious direct link to health outcomes, and the policy implications are often unclear (2). A complementary approach involves the use of tracer conditions (3), which is based on the premise that focusing on carefully selected health problems makes it possible to identify weaknesses in elements of the health system and to obtain more direct insight into its performance.The rising burden of chronic diseases worldwide demands measures that will capture differences in the care provided to those affected, and we propose diabetes as a suitable tracer condition; it is well defined, fairly easy to diagnose (4), and common. The prevalence worldwide is estimated to be 2.8% (2000) and expected to increase to 4.4% by 2030 (5), with this figure already exceeded in the U.S. (6). While mainly type 2 diabetes is increasing, type 1 diabetes is also increasing swiftly, at ϳ3% per year, especially in Central and Eastern Europe and among young children (7).Health system performance affects diabetes outcomes in several ways. Effective treatment reduces the risk of disabling or fatal complications (8 -10). This is most apparent for type 1 diabetes in developing countries where access to insulin is extremely limited (11). However, it is also seen where h...

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Markedly increased renal disease mortality and incidence of renal replacement therapy among IDDM patients in Japan in contrast to Allegheny County, Pennsylvania, USA

Cited by 29 publications

References 20 publications

Age at Onset of Childhood-Onset Type 1 Diabetes and the Development of End-Stage Renal Disease

Age at Onset of Childhood-Onset Type 1 Diabetes and the Development of End-Stage Renal Disease

Recent trends in life expectancy for people with type 1 diabetes in Sweden

Diabetes as a Tracer Condition in International Benchmarking of Health Systems

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