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Cited by 121Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and ResearchDiabetes Management and Education

Risk Factors for Mortality Among Patients With Diabetes

McEwen, Laura N., Kim, Catherine, Karter, Andrew J., Haan, Mary N., Ghosh, Debashis, Lantz, Paula M., Mangione, Carol M., Thompson, Theodore J. +1 more·2007·Diabetes Care
DOI 10.2337/dc07-0305
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Abstract

OBJECTIVE— We sought to examine demographic, socioeconomic, and biological predictors of all-cause, cardiovascular, and noncardiovascular mortality in patients with diabetes. RESEARCH DESIGN AND METHODS— Survey, medical record, and administrative data were obtained from 8,733 participants in the Translating Research Into Action for Diabetes Study, a multicenter, prospective, observational study of diabetes care in managed care. Data on deaths (n = 791) and cause of death were obtained from the National Death Index after 4 years. Predictors examined included age, sex, race, education, income, duration, and treatment of diabetes, BMI, smoking, microvascular and macrovascular complications, and comorbidities. RESULTS— Predictors of adjusted all-cause mortality included older age (hazard ratio [HR] 1.04 [95% CI 1.03–1.05]), male sex (1.57 [1.35–1.83]), lower income (<$15,000 vs. >$75,000, HR 1.82 [1.30–2.54]; $15,000–$40,000 vs. >$75,000, HR 1.58 [1.15–2.17]), longer duration of diabetes (≥9 years vs. <9 years, HR 1.20 [1.02–1.41]), lower BMI (<26 vs. 26–30 kg/m2, HR 1.43 [1.13–1.69]), smoking (1.44 [1.20–1.74]), nephropathy (1.46 [1.23–2.73]), macrovascular disease (1.46 [1.23–1.74]), and greater Charlson index (≥2–3 vs. <1, HR 2.01 [1.04–3.90]; ≥3 vs. <1, HR 4.38 [2.26–8.47]). The predictors of cardiovascular and noncardiovascular mortality were different. Macrovascular disease predicted cardiovascular but not noncardiovascular mortality. CONCLUSIONS— Among people with diabetes and access to medical care, older age, male sex, smoking, and renal disease are important predictors of mortality. Even within an insured population, socioeconomic circumstance is an important independent predictor of health.

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Authors
McEwen, L. N., Kim, C., Karter, A. J., Haan, M. N., Ghosh, D., Lantz, P. M., Mangione, C. M., Thompson, T. J., & Herman, W. H.
Affiliations
  • University of Michigan (US)
  • Kaiser Permanente (US)
  • University of California, Los Angeles (US)
  • Centers for Disease Control and Prevention (US)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2007-07-01
Volume
30
Issue
7
Pages
1736-1741
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc07-0305
OpenAlex
W2166486050
Cited by
121
References
31
Citations by year
2026: 5 · 2025: 2 · 2024: 2 · 2023: 6 · 2022: 4 · 2021: 4 · 2020: 8 · 2019: 6 · 2018: 3 · 2017: 3 · 2016: 7 · 2015: 8 · 2014: 15 · 2013: 6 · 2012: 14
FWCI
5.60
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Centers for Disease Control and Prevention
  • National Institute of Diabetes and Digestive and Kidney Diseases
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
diabetes mortality, all-cause mortality, cardiovascular mortality, non-cardiovascular mortality, socioeconomic status, income, smoking, kidney disease, macroangiopathy, Charlson Comorbidity Index, diabetes duration, body mass index, sex differences, old age, managed care, mortality risk factors, diabetes complications, comorbidities
MeSH terms
Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Female, Follow-Up Studies, Humans, Male, Managed Care Programs, Middle Aged, Prospective Studies, Risk Factors, Socioeconomic Factors

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