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Early mortality in EURODIAB population-based cohorts of type 1 diabetes diagnosed in childhood since 1989
Open accessAbstract
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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“and accounts for 13–19% of type 1 diabetes-related mortality.105,110,111”
From Type 1 diabetes (2018) · cites this paper as [111]
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“and are associated with 4–10% of type 1 diabetes-related deaths.110–112”
From Type 1 diabetes (2018) · cites this paper as [111]
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“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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“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]
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“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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Metadata
- 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
- Published
- 2007-09-28
- Volume
- 50
- Issue
- 12
- Pages
- 2439-2442
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- 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
- bronze
- doi.org
- 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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