Risk of Cardiovascular Disease and Total Mortality in Adults with Type 1 Diabetes: Scottish Registry Linkage Study

Livingstone, Shona; Looker, Helen C.; Hothersall, Eleanor J; Wild, Sarah H.; Lindsay, Robert; Chalmers, John; Cleland, Stephen J.; Leese, Graham; McKnight, John; Morris, Andrew D.; Pearson, Donald; Peden, N. R.; Petrie, John R.; Philip, Sam; Sattar, Naveed; Sullivan, Frank; Colhoun, Helen M.

doi:10.1371/journal.pmed.1001321

Cited by 285 publications

(276 citation statements)

References 31 publications

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“…It was shown in a Norwegian publication that for those diagnosed between 1973 and 1982 the SMR was 4.0 after a mean diabetes duration of 24 years [2]. This was similar to what we found when the cohort was followed for a further 10 years (Table 1) and was consistent with findings from other studies where SMRs tended to increase with attained age up to approximately 30-40 years [6,16,22,29]. For women, the maximum SMR in our study occurred around the same time as that in a Danish study [16], but about 10 years later than was found in two studies from the UK [6,29].…”

Section: Discussionsupporting

confidence: 91%

All-cause mortality in a nationwide cohort of childhood-onset diabetes in Norway 1973–2013

et al. 2015

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Aims/hypothesis The aim of this study was to assess the association between all-cause mortality and sex, age at diagnosis and year of diagnosis in Norwegian patients with childhoodonset diabetes. Methods The study was based on the nationwide, populationbased Norwegian Childhood Diabetes Registry, which includes all newly diagnosed cases of childhood-onset diabetes at age 0-14 years in 1973-1982 and 1989-2012 (n=7,884). Patients were followed until date of death, emigration or 30 September 2013. Results Among the 7,884 patients, representing 132,420 person-years, 249 (3.2%) died during a mean follow-up of 16.8 (range 0.0-40.7) years. The standardised mortality ratio (SMR) for the total cohort was 3.6 (95% CI 3.1, 4.0), increasing by attained age. Absolute mortality was significantly lower in females than in males (HR 0.50 [95% CI 0.38, 0.65]), although the SMRs were similar. Cox regression analysis showed a significant decrease in mortality of 49% (HR 0.51 [95% CI 0.28, 0.93]) for those diagnosed in 1999-2012 compared with those diagnosed in 1973-1982 (p=0.03). Conclusions/interpretation In spite of improved diabetes care, mortality is still three to four times higher in those with childhood-onset diabetes compared with the general population in Norway. However, absolute mortality has declined among children diagnosed most recently (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012) compared with those diagnosed in the earliest period (1973)(1974)(1975)(1976)(1977)(1978)(1979)(1980)(1981)(1982).

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Section: Discussionsupporting

confidence: 91%

All-cause mortality in a nationwide cohort of childhood-onset diabetes in Norway 1973–2013

et al. 2015

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“…Type 1 diabetes is associated with substantially increased rates of morbidity and mortality, accounting for costs exceeding $14.9 billion in health care costs in the U.S. each year (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). It is characterized by decreased insulin secretion and severe hyperglycemia, which can lead to ketoacidosis, coma and death.…”

Section: Introductionmentioning

confidence: 99%

Galantamine Attenuates Type 1 Diabetes and Inhibits Anti-Insulin Antibodies in Nonobese Diabetic Mice

Hanes

Olofsson

Kwan

et al. 2015

Mol Med

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Type 1 diabetes in mice is characterized by autoimmune destruction of insulin-producing pancreatic β-cells. Disease pathogenesis involves invasion of pancreatic islets by immune cells, including macrophages and T cells, and production of antibodies to self-antigens, including insulin. Activation of the inflammatory reflex, the neural circuit that inhibits inflammation, culminates on cholinergic receptor signals on immune cells to attenuate cytokine release and inhibit B-cell antibody production. Here, we show that galantamine, a centrally acting acetylcholinesterase inhibitor and an activator of the inflammatory reflex, attenuates murine experimental type 1 diabetes. Administration of galantamine to animals immunized with keyhole limpet hemocyanin (KLH) significantly suppressed splenocyte release of immunoglobulin G (IgG) and interleukin (IL)-4 and IL-6 during KLH challenge ex vivo. Administration of galantamine beginning at 1 month of age in nonobese diabetic (NOD) mice significantly delayed the onset of hyperglycemia, attenuated immune cell infiltration in pancreatic islets and decreased anti-insulin antibodies in serum. These observations indicate that galantamine attenuates experimental type 1 diabetes in mice and suggest that activation of the inflammatory reflex should be further studied as a potential therapeutic approach.

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“…17,19,20 Reports from Scotland, Australia, and Norway show that both acute and chronic complications of diabetes contribute to the excess mortality in persons with type 1 diabetes. [21][22][23] Sudden death, including those discovered dead-in-bed accounted for 22% of the deaths in persons dying under age 40 with type 1 diabetes in the Australian study and 5% of those dying before age 30 in the Norwegian cohort. 21,24 One case report confirmed hypoglycemia as the cause of deadin-bed syndrome, and a recent report by Novodvorsky et al confirms that cardiac arrhythmias and repolarization occur during asymptomatic nocturnal hypoglycemia more commonly than daytime hypoglycemia.…”

Section: Cgm In Type 1 Diabetes Treated With MDImentioning

confidence: 99%

Continuous Glucose Monitoring with Multiple Daily Insulin Treatment: Outcome Studies

McGill

Ahmann

2017

Diabetes Technology & Therapeutics

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Continuous glucose monitoring (CGM) is developing into an increasingly useful tool for glucose monitoring and therapeutic guidance in the treatment of diabetes. Multiple daily doses of insulin (MDI) is the most common method for intensive insulin treatment of type 1 diabetes and is also becoming more common in the treatment of type 2 diabetes as an increasing population with type 2 diabetes experiences progressive beta cell loss. The clinical evidence demonstrating the benefit of CGM in the outcomes of patients treated with MDI is becoming clearer, particularly with the recent completion of several randomized clinical trials addressing both type 1 and 2 diabetes. This evidence is reviewed.

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Risk of Cardiovascular Disease and Total Mortality in Adults with Type 1 Diabetes: Scottish Registry Linkage Study

Abstract: Helen Colhoun and colleagues report findings from a Scottish registry linkage study regarding contemporary risks for cardiovascular events and all-cause mortality among individuals diagnosed with type 1 diabetes.

Cited by 285 publications

References 31 publications

All-cause mortality in a nationwide cohort of childhood-onset diabetes in Norway 1973–2013

All-cause mortality in a nationwide cohort of childhood-onset diabetes in Norway 1973–2013

Galantamine Attenuates Type 1 Diabetes and Inhibits Anti-Insulin Antibodies in Nonobese Diabetic Mice

Continuous Glucose Monitoring with Multiple Daily Insulin Treatment: Outcome Studies

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