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Cited by 213Diabetes Management and ResearchDiabetes and associated disordersDiabetes Management and Education

Early mortality in EURODIAB population-based cohorts of type 1 diabetes diagnosed in childhood since 1989

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Patterson, C. C., Dahlquist, G., Harjutsalo, V., Joner, G., Feltbower, R. G., Svensson, J., Schober, E., Gyürüs, E. +6 more·2007·Diabetologia
DOI 10.1007/s00125-007-0824-8
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Abstract

Aims/hypothesis The aims of this study were to provide a contemporary picture of mortality and causes of death in Europe following a diagnosis of type 1 diabetes made before the 15th birthday, and to examine excess mortality by country for possible links to incidence level or national prosperity.Methods Thirteen population-based EURODIAB registers in 12 countries followed-up 28,887 children diagnosed since 1989, either by record linkage to population registers or through contact with doctors providing care.Results There were 141 deaths in the cohort during 219,061 person-years of follow-up compared with 69.1 deaths expected from national mortality rates, a standardised mortality ratio (SMR) of 2.0 (95% CI 1.7-2.4). The SMR varied from 0 to 4.7 between countries, but showed little relationship with the country's incidence rate or gross domestic product (US$ per capita). The SMR did not change significantly with attained age, calendar period or time since diagnosis. The female SMR (2.7; 95% CI 2.0-3.5) was greater than the male SMR (1.8; 95% CI 1.4-2.2), although absolute numbers of excess deaths were similar in the two sexes. One-third of deaths were classified as directly attributable to diabetes (many with mention of ketoacidosis) and half were unrelated to diabetes. There was a non-significant excess of accidental/violent deaths (48 observed vs 40.7 expected; SMR 1.2; 95% CI 0.9-1.6) but little excess in suicides (11 observed, 10.2 expected; SMR 1.1; 95% CI 0.5-1.9).Conclusions/interpretation Before the onset of late complications, significant excess mortality existed following the diagnosis of type 1 diabetes in childhood, even in recent years. Variation between countries in this excess could not be explained.

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  • Diabetic ketoacidosis accounts for 13-19% of type 1 diabetes-related mortality.

    “and accounts for 13–19% of type 1 diabetes-related mortality.105,110,111”

    From Type 1 diabetes (2018) · cites this paper as [111]

    The Results (page unavailable) report diabetic ketoacidosis mentioned in 27 of 141 deaths among people with type 1 diabetes, approximately 19%. But only 47 deaths were classified as directly attributable to diabetes; ketoacidosis was mentioned in 27 of those, approximately 57%. The paper therefore supports the 19% figure only for all deaths in the cohort, not a 13–19% range for deaths attributable to diabetes. (LLM, conf=0.86)

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  • Hypoglycaemic events are associated with 4-10% of type 1 diabetes-related deaths.

    “and are associated with 4–10% of type 1 diabetes-related deaths.110–112”

    From Type 1 diabetes (2018) · cites this paper as [111]

    The Results report five deaths directly ascribed to hypoglycaemia among 47 deaths assessed as directly attributable to diabetes—about 11% in this childhood-onset European cohort. The paper does not report a 4–10% range for diabetes-related deaths or establish that range beyond this cohort. (LLM, conf=0.83)

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  • In four series, 4%, 6%, 7%, and 10% of deaths of patients with type 1 diabetes were caused by hypoglycemia.

    “four recent reports of mortality rates in series of patients indicate that 4% (27), 6% (28), 7% (29), and 10% (30) of deaths of patients with type 1 diabetes were caused by hypoglycemia.”

    From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [27]

  • Despite abundant data on the importance of controlling blood pressure and dyslipidemia, adequate control of these vascular disease risk factors is frequently not achieved.

    “Despite abundant data on the importance of control of blood pressure and dyslipidemia, adequate control of these vascular disease risk factors is frequently not achieved121,122.”

    From Epidemiology of type 1 diabetes (2010) · cites this paper as [122]

  • Four recent reports of mortality rates in series of patients indicate that 4%, 6%, 7%, and 10% of deaths of patients with type 1 diabetes were caused by hypoglycemia.

    “In addition to case reports of hypoglycemic deaths in patients with type 1 and type 2 diabetes, four recent reports of mortality rates in series of patients indicate that 4% (27), 6% (28), 7% (29), and 10% (30) of deaths of patients with type 1 diabetes were caused by hypoglycemia.”

    From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [27]

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Authors
Patterson, C. C., Dahlquist, G., Harjutsalo, V., Joner, G., Feltbower, R. G., Svensson, J., Schober, E., Gyürüs, E., Castell, C., Urbonaité, B., Rosenbauer, J., Iotova, V., Thorsson, A. V., & Soltész, G.
Affiliations
  • Queen's University Belfast (GB)
  • Umeå University (SE)
  • Oslo University Hospital (NO)
  • University of Leeds (GB)
  • Glostrup Hospital (DK)
  • University of Vienna (AT)
  • Departament de Salut (ES)
  • Deutsches Diabetes-Zentrum e.V. (DE)
  • Medical University of Varna (BG)
  • University of Pecs (HU)
Corresponding author
Patterson, C. C.
ORCID
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
2007-09-28
Volume
50
Issue
12
Pages
2439-2442
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/s00125-007-0824-8
OpenAlex
W2061608615
Cited by
213
References
12
Citations by year
2026: 2 · 2025: 3 · 2024: 18 · 2023: 10 · 2022: 13 · 2021: 12 · 2020: 14 · 2019: 10 · 2018: 16 · 2017: 11 · 2016: 15 · 2015: 21 · 2014: 14 · 2013: 19 · 2012: 5
FWCI
4.35
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Diabetologia (publishedVersion)
  • PubMed (publishedVersion)
  • Lithuanian University of Health Sciences (submittedVersion)
  • Research Portal (Queen's University Belfast) (submittedVersion)
  • Hirsla (Landspítali University Hospital) (submittedVersion)
Funders
  • Universität Wien
  • Vetenskapsrådet
  • Medizinische Universität Wien
  • Socialstyrelsen
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
type 1 diabetes, childhood-onset diabetes, excess mortality, causes of death, standardized mortality ratio, sex differences in mortality, suicide, diabetic ketoacidosis, gross domestic product
MeSH terms
Adolescent, Adult, Cause of Death, Child, Child, Preschool, Diabetes Mellitus, Type 1, Europe, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Male, Registries, Cohort Studies, Age of Onset

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