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Diabetologia

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01-04-2006 | Article

Excess mortality in incident cases of diabetes mellitus aged 15 to 34 years at diagnosis: a population-based study (DISS) in Sweden

Authors: I. Waernbaum, G. Blohmé, J. Östman, G. Sundkvist, J. W. Eriksson, H. J. Arnqvist, J. Bolinder, L. Nyström

Published in: Diabetologia | Issue 4/2006

Abstract

Aims/hypothesis

The objective of the study was to analyse the mortality, survival and cause of death patterns in incident cases of diabetes in the 15–34-year age group that were reported to the nationwide prospective Diabetes Incidence Study in Sweden (DISS).

Materials and methods

During the study period 1983–1999, 6,771 incident cases were reported. Identification of deaths was made by linking the records to the nationwide Cause of Death Register.

Results

With an average follow-up of 8.5 years, resulting in 59,231 person-years, 159 deaths were identified. Diabetes was reported as the underlying cause of death in 51 patients (32%), and as a contributing cause of death in another 42 patients (26%). The standardised mortality ratio (SMR) was significantly elevated (RR=2.4; 95% CI: 2.0–2.8). The SMR was higher for patients classified by the reporting physician as having type 2 diabetes at diagnosis than for those classified as type 1 diabetic (2.9 and 1.8, respectively). Survival analysis showed significant differences in survival curves between males and females (p=0.0003) as well as between cases with different types of diabetes (p=0.005). This pattern was also reflected in the Cox regression model showing significantly increased hazard for males vs females (p=0.0002), and for type 2 vs type 1 (p=0.015) when controlling for age.

Conclusions/interpretation

This study shows a two-fold excess mortality in patients with type 1 diabetes and a three-fold excess mortality in patients with type 2 diabetes. Thus, despite advances in treatment, diabetes still carries an increased mortality in young adults, even in a country with a good economic and educational patient status and easy access to health care.

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Title: Excess mortality in incident cases of diabetes mellitus aged 15 to 34 years at diagnosis: a population-based study (DISS) in Sweden
Authors: I. Waernbaum
G. Blohmé
J. Östman
G. Sundkvist
J. W. Eriksson
H. J. Arnqvist
J. Bolinder
L. Nyström
Publication date: 01-04-2006
Publisher: Springer-Verlag
Published in: Diabetologia / Issue 4/2006
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-005-0135-x

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