Mortality risk in people with type 2 diabetes: a large prospective population-based cohort study (The Ayrshire Diabetes fOllow-up Cohort (ADOC) study)

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background</jats:bold>The aims of this study were to investigate the effects of age, gender, body mass index (BMI), glycaemic control, socio-economic status, dyslipidaemia, hypertension, ischaemic heart disease (IHD) and smoking status in type 2 diabetes in a population-based analysis. <jats:bold>Methods</jats:bold>Data were collected from 46 General Practice databases in 2009 and 2014. Cox regressions were run in the non-diabetes population plus type 2 diabetes patients. <jats:bold>Results</jats:bold>People with type 2 diabetes (n=16,643) had higher mortality rates than non-diabetes subjects. Ranked in order of Hazard Ratio (HR), increasing age (HR 2.31), smoking (HR 1.79), IHD (HR 1.65), deprivation (HR 1.36), hypertension (HR 1.23) and male gender (HR 1.20) all increased mortality risk (p&lt;0.01). Statin therapy was associated with better outcome (HR 0.65, p&lt;0.01). Abnormal lipid levels whilst not on a statin significantly increased mortality risk for raised total-cholesterol (HR 1.74) and low HDL-cholesterol (HR 1.48) but not for triglycerides (HR 0.67) (all p&lt;0.01). <jats:bold>Conclusions</jats:bold>This large study confirmed that the all-cause mortality risk in people with type 2 diabetes remains elevated. In the study we demonstrated that a man with type 2 diabetes of 5-10 years duration who smoked, had hypertension and IHD plus lived in the most deprived area had a HR of 6.2 compared with a non-smoking, normotensive, non-diabetes subject without IHD living in the least deprived area. . Further research is required to understand the gender risk difference in all-cause mortality in type 1 compared with type 2 diabetes and why obesity plus raised triglycerides appear to be protective.</jats:p>