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Mortality risk remains high for certain patients with type 2 diabetes
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Compared with the general population, mortality risks among those with type 2 diabetes varies greatly, with substantial risks in some groups to lower risks in others, depending on age, glycemic control and renal complications, according to recent study findings published in The New England Journal of Medicine.
Marcus Lind, MD, PhD, of the department of medicine at Uddevalla Hospital in Sweden, and colleagues evaluated data from the Swedish National Diabetes Register on patients with type 2 diabetes registered on or after Jan. 1, 1998. Each patient was matched with controls for comparison. Patients were followed until Dec. 31, 2011, using data from the Swedish Registry for Cause-Specific Mortality. Researchers sought to determine the risk for mortality according to glycemic control and renal complications.
Marcus Lind
Mean follow-up was 4.6 years in the group with diabetes and 4.8 years among controls.
The overall death rate per 1,000 person-years was greater among the diabetes group (17.7%) compared with controls (14.5%). Similarly, cardiovascular mortality was greater among the diabetes group (17.15 per 1,000) compared with controls (12.86 per 1,000).
Compared with controls, the excess risk for death was twice as high among the diabetes group with a time-updated HbA1c of 6.9% or less and in those who were younger than 55 years (HR for death from any cause = 1.92; 95% CI, 1.75-2.11; HR for CV death = 2.18; 95% CI, 1.81-2.64). Lower risks for deaths were found among participants aged 75 years or older compared with controls (HR for death from any cause = 0.95; 95% CI, 0.94-0.96; HR for CV death = 0.92; 95% CI, 0.9-0.94). Compared with controls, the excess risk for death was twice as high among those in the diabetes group who had normoalbuminuria and were younger than 55 years (HR death from any cause = 1.87; 95% CI, 1.7-2.04; HR for CV death = 2.19; 95% CI, 1.82-2.62). However, a lower risk was found among patients with normoalbuminuria who were aged 65 to 74 years or 75 years or older.
“In conclusion, the overall excess risk of death among persons with type 2 diabetes has dropped to a historically low level of approximately 15%,” the researchers wrote. “However, mortality remains high in certain patient groups and remains substantially higher among patients younger than 55 years of age, as compared with controls, even among patients whose glycemic values are within the target range and who have normoalbuminuria.” – by Amber Cox
Disclosure: Lind reports receiving grants and/or personal fees from Abbott Scandinavia, AstraZeneca, Bayer, Dexcom, Diabetes Wellness, Eli Lilly, Medtronic, Novo Nordisk, Pfizer, Region Västra Götaland, Rubin Medical, the Swedish Heart and Lung Foundation, The Swedish Society of Medicine and the Swedish State. Please see the full study for a list of all other authors’ relevant financial disclosures.
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