Dataset Information

Cause-specific mortality trends in a large population-based cohort with long-standing childhood-onset type 1 diabetes.

ABSTRACT:

Objective

Little is known concerning the primary cause(s) of mortality in type 1 diabetes responsible for the excess mortality seen in this population.

Research design and methods

The Allegheny County (Pennsylvania) childhood-onset (age < 18 years) type 1 diabetes registry (n = 1,075) with diagnosis from 1965 to 1979 was used to explore patterns in cause-specific mortality. Cause of death was determined by a mortality classification committee of at least three physician epidemiologists, based on the death certificate and additional records surrounding the death.

Results

Vital status for 1,043 (97%) participants was ascertained as of 1 January 2008, revealing 279 (26.0%) deaths overall (141 females and 138 males). Within the first 10 years after diagnosis, the leading cause of death was acute diabetes complications (73.6%), while during the next 10 years, deaths were nearly evenly attributed to acute (15%), cardiovascular (22%), renal (20%), or infectious (18%) causes. After 20 years' duration, chronic diabetes complications (cardiovascular, renal, or infectious) accounted for >70% of all deaths, with cardiovascular disease as the leading cause of death (40%). Women (P < 0.05) and African Americans (P < 0.001) have significantly higher diabetes-related mortality rates than men and Caucasians, respectively. Standardized mortality ratios (SMRs) for non-diabetes-related causes do not significantly differ from the general population (violent deaths: SMR 1.2, 95% CI 0.6-1.8; cancer: SMR 1.2, 0.5-2.0).

Conclusions

The excess mortality seen in type 1 diabetes is almost entirely related to diabetes and its comorbidities but varies by duration of diabetes and particularly affects women and African Americans.

SUBMITTER: Secrest AM

PROVIDER: S-EPMC2992785 | biostudies-literature | 2010 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Cause-specific mortality trends in a large population-based cohort with long-standing childhood-onset type 1 diabetes.

Secrest Aaron M AM Becker Dorothy J DJ Kelsey Sheryl F SF Laporte Ronald E RE Orchard Trevor J TJ

Diabetes 20100825 12

<h4>Objective</h4>Little is known concerning the primary cause(s) of mortality in type 1 diabetes responsible for the excess mortality seen in this population.<h4>Research design and methods</h4>The Allegheny County (Pennsylvania) childhood-onset (age < 18 years) type 1 diabetes registry (n = 1,075) with diagnosis from 1965 to 1979 was used to explore patterns in cause-specific mortality. Cause of death was determined by a mortality classification committee of at least three physician epidemiolo ...[more]

PMID: 20739685

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Dataset Information

Cause-specific mortality trends in a large population-based cohort with long-standing childhood-onset type 1 diabetes.

Objective

Research design and methods

Results

Conclusions

Publications

Cause-specific mortality trends in a large population-based cohort with long-standing childhood-onset type 1 diabetes.

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