Mortality risk remains higher in individuals with type 1 diabetes: A population‐based cohort study (the Ayrshire diabetes follow‐up cohort [ADOC])

Collier, Andrew; Connelly, Paul; Hair, Mario; Cameron, Lyall; Ghosh, Sujoy; Waugh, Norman

doi:10.1111/dom.13334

Cited by 10 publications

(23 citation statements)

References 26 publications

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“…In ADOC study, T1D patients had higher mortality rates than nondiabetic controls, and ischaemic heart disease was one of the factors that increased mortality risk. Interestingly, in this study, obesity was associated with lower mortality, and this effect has been called “obesity paradox” . Few studies also suggested higher relative risk of mortality in females than in males with T1D …”

Section: Overweight and Obesity In T1dmentioning

confidence: 69%

“…Interestingly, in this study, obesity was associated with lower mortality, and this effect has been called "obesity paradox". 32 Few studies also suggested higher relative risk of mortality in females than in males with T1D. 32,33 Another complication of T1D, which is also related to CVD, is diabetic nephropathy (diabetic kidney disease-DKD).…”

Section: Obesity and T1d Complicationsmentioning

confidence: 99%

“…32 Few studies also suggested higher relative risk of mortality in females than in males with T1D. 32,33 Another complication of T1D, which is also related to CVD, is diabetic nephropathy (diabetic kidney disease-DKD). 34 In patients with T1D with DKD, obesity is twice as common as among those without concomitant DKD.…”

Section: Obesity and T1d Complicationsmentioning

confidence: 99%

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Obesity and diabetes—Not only a simple link between two epidemics

Chobot¹,

Górowska-Kowolik²,

Sokołowska

et al. 2018

Diabetes Metabolism Res

221

158

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SummaryDiabetes (DM) as well as obesity, due to their increasing incidence, were recognized as epidemic by the World Health Organization. Obesity is involved not only in the aetiopathogenesis of the most common worldwide type of DM—type 2 diabetes—but also in the development of its complications. There is also increasing scientific evidence regarding the role of obesity and overweight in type 1 diabetes. Weight gain may be considered as a complication of insulin treatment but also reveals significant pathophysiological impact on various stages of the disease. Another very important aspect related to DM as well as obesity is the microbiome, which is highly variable. The function of the gut microflora, its interaction with the whole organism, and its role in the development of obesity and type 1 diabetes as well as type 2 diabetes are still not fully understood and subject of ongoing investigations. This review presents a summary of recently published results concerning the relation of obesity/overweight and DM as well as their associations with the microbiome.

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Section: Overweight and Obesity In T1dmentioning

confidence: 69%

Section: Obesity and T1d Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Obesity and diabetes—Not only a simple link between two epidemics

Chobot¹,

Górowska-Kowolik²,

Sokołowska

et al. 2018

Diabetes Metabolism Res

221

158

View full text Add to dashboard Cite

show abstract

“…In a recently published study, we investigated the outcome of patients with type 1 diabetes over the same ve-year period where further information on methodology is available. [11]. Survival was measured in days from a 'start date' of 1/10/2009 to an 'end date' of 30/09/2014.…”

Section: Methodsmentioning

confidence: 99%

“…Interactions of diabetes groups with all the other covariates were also included. Reference group were female, quintile 1 (least deprived), non-diabetes, nonsmoker, normotensive and no IHD [11].…”

Section: Statisticsmentioning

confidence: 99%

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

Collier

Hair

Cameron

et al. 2020

Preprint

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Abstract BackgroundThe 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. MethodsData 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. ResultsPeople 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<0.01). Statin therapy was associated with better outcome (HR 0.65, p<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<0.01). ConclusionsThis 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.

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Overweight and obesity in type 1 diabetes equal those of the general population

Fellinger

Fuchs

Wolf

et al. 2019

Wien Klin Wochenschr

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Summary Background The obesity epidemic might affect patients with type 1 diabetes (T1DM), historically described as lean and insulin-sensitive subjects. Insulin resistance in T1DM might increase diabetic complications, especially cardiovascular disease. Therefore, the body mass index (BMI) in T1DM patients was analyzed in comparison to the general population. Furthermore, the impact of increased BMI on glycemic control and metabolic alterations was assessed. Methods Body mass index was compared overall and among four different age groups between adult T1DM ( n = 186), treated in the outpatient clinic between 2014 and 2016, and 15,771 individuals from the general population who took part at an Austrian health survey. Furthermore, parameters of glycemic control, lipid state, blood pressure and additional medication were compared between T1DM with a BMI under or above 27.5 kg/m 2 . Results Patients with T1DM had significantly higher BMI values than general population (25.9 ± 4.2 kg/m 2 vs. 25.3 ± 4.5 kg/m 2 ; p = 0.027), controlling for age group; however, prevalence of overweight (39.8% vs. 33.1%) and obesity (14% vs. 13.8%) was not significantly different. Within the 4 age groups only T1DM patients between 30 years and 49 years old had significantly higher BMI values compared to the general population (mean difference 1.9 kg/m 2 ; 95% confidence interval, CI: 0.96–2.83 kg/m 2 ). In T1DM, a BMI ≥27.5 kg/m 2 was associated with increased rates of hypertension, dyslipidemia, microalbuminuria, and increased insulin demand, whereas glycemic control was not affected. Conclusions In contrast to common descriptions T1DM patients have a higher BMI compared to the general population. Rates of overweight and obesity in T1DM equal those of the general population. Therefore, it is concluded that the obesity epidemic has reached T1DM patients and “double diabetes” might be an entity to consider.

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Mortality risk remains higher in individuals with type 1 diabetes: A population‐based cohort study (the Ayrshire diabetes follow‐up cohort [ADOC])

Abstract: This study confirmed that the risk of mortality in individuals with type 1 diabetes remains elevated. Further studies are required to understand how gender affects the disparity in mortality and why obesity appears to be protective.

Cited by 10 publications

References 26 publications

Obesity and diabetes—Not only a simple link between two epidemics

Obesity and diabetes—Not only a simple link between two epidemics

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

Overweight and obesity in type 1 diabetes equal those of the general population

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