Mortality trends in type 1 diabetes: a multicountry analysis of six population-based cohorts.

Consortium Mortality Non-communicable disease Population health Trends Type 1 diabetes

Journal

Diabetologia
ISSN: 1432-0428
Titre abrégé: Diabetologia
Pays: Germany
ID NLM: 0006777

Informations de publication

Date de publication:
06 2022
Historique:
received: 07 10 2021
accepted: 30 11 2021
pubmed: 23 3 2022
medline: 11 5 2022
entrez: 22 3 2022
Statut: ppublish

Résumé

Mortality has declined in people with type 1 diabetes in recent decades. We examined how the pattern of decline differs by country, age and sex, and how mortality trends in type 1 diabetes relate to trends in general population mortality. We assembled aggregate data on all-cause mortality during the period 2000-2016 in people with type 1 diabetes aged 0-79 years from Australia, Denmark, Latvia, Scotland, Spain (Catalonia) and the USA (Kaiser Permanente Northwest). Data were obtained from administrative sources, health insurance records and registries. All-cause mortality rates in people with type 1 diabetes, and standardised mortality ratios (SMRs) comparing type 1 diabetes with the non-diabetic population, were modelled using Poisson regression, with age and calendar time as quantitative variables, describing the effects using restricted cubic splines with six knots for age and calendar time. Mortality rates were standardised to the age distribution of the aggregate population with type 1 diabetes. All six data sources showed a decline in age- and sex-standardised all-cause mortality rates in people with type 1 diabetes from 2000 to 2016 (or a subset thereof), with annual changes in mortality rates ranging from -2.1% (95% CI -2.8%, -1.3%) to -5.8% (95% CI -6.5%, -5.1%). All-cause mortality was higher for male individuals and for older individuals, but the rate of decline in mortality was generally unaffected by sex or age. SMR was higher in female individuals than male individuals, and appeared to peak at ages 40-70 years. SMR declined over time in Denmark, Scotland and Spain, while remaining stable in the other three data sources. All-cause mortality in people with type 1 diabetes has declined in recent years in most included populations, but improvements in mortality relative to the non-diabetic population are less consistent.

Identifiants

pubmed: 35314870
doi: 10.1007/s00125-022-05659-9
pii: 10.1007/s00125-022-05659-9
pmc: PMC9076725
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

964-972

Informations de copyright

© 2022. The Author(s).

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Auteurs

Paz L D Ruiz (PLD)

Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway.
Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.

Lei Chen (L)

Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.

Jedidiah I Morton (JI)

Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Agus Salim (A)

Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.

Bendix Carstensen (B)

Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark.

Edward W Gregg (EW)

Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.

Meda E Pavkov (ME)

Division of Diabetes Translation, Centers for Diseases Control and Prevention, Atlanta, GA, USA.

Manel Mata-Cases (M)

Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain.
Institut Català de la Salut, Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.

Didac Mauricio (D)

Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain.
Institut Català de la Salut, Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
Department of Endocrinology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain.

Gregory A Nichols (GA)

Science Programs Department, Kaiser Permanente Center for Health Research, Portland, OR, USA.

Santa Pildava (S)

Research and Health Statistics Department, Centre for Disease Prevention and Control, Riga, Latvia.

Stephanie H Read (SH)

Usher Institute, University of Edinburgh, Edinburgh, UK.

Sarah H Wild (SH)

Usher Institute, University of Edinburgh, Edinburgh, UK.

Jonathan E Shaw (JE)

Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
School of Life Sciences, La Trobe University, Melbourne, VIC, Australia.

Dianna J Magliano (DJ)

Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia. Dianna.Magliano@monash.edu.
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. Dianna.Magliano@monash.edu.

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