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Cited by 17Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and ResearchDiabetes Treatment and Management

Why Do People With Diabetes Die Too Soon?

Open access
Rewers, Marian·2008·Diabetes Care
DOI 10.2337/dc08-0245
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Abstract

The excess mortality among people with diabetes and the role of cardiovascular disease (CVD) in shortening their lives have been recognized for decades (1–3). Recent studies suggest that all-cause mortality (4) and CVD incidence among people with diabetes (5) are declining; however, the proportion of CVD attributable to diabetes has increased over the past 50 years, largely due to the increase in diabetes prevalence (6). Furthermore, mortality follow-up of the National Health and Nutrition Examination Survey (NHANES) I, II, and III participants may suggest that despite some progress in reducing mortality in men with diabetes, women are still at a greatly increased risk (7). The vital question for an estimated 200 million people with diabetes worldwide today (8) is what to do to improve life expectancy and quality. A study from Finland in this issue of Diabetes Care by Juutilainen et al. (9) attempts to shed some light on modifiable determinants of survival among patients diagnosed with diabetes after age 30 years. In a cohort of 173 type 1 and 834 type 2 diabetic patients followed for 18 years, the total mortality risk was increased threefold and CVD mortality was increased fivefold compared with the general population, confirming previous studies. The comparisons were adjusted for age, sex, duration of diabetes, area of residence, BMI, blood pressure, total and HDL cholesterol, proteinuria, creatinine clearance, smoking, and alcohol intake measured at baseline. Consistent with many previous reports, the increase in CVD mortality risk was much more dramatic in diabetic women (11- to 13-fold) than in diabetic men (3- to 4-fold) compared with the general population. The increase in total mortality risk was less pronounced: ∼4.5-fold in women and 2-fold in men, respectively. The novel finding appears to be that total and CVD mortality similarly affects patients with type 1 and …

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  • Data suggest that care for type 1 diabetes has improved, as evidenced by reduced rates of microvascular disease in past decades, whereas data on cardiovascular disease suggest substantially less progress in reducing macrovascular disease rates.

    “Furthermore, there are data to suggest that care for T1D has improved as evidenced by reduced rates of microvascular disease in the past decades109–111, whereas data on CVD suggest that substantially less progress has been made in reduction of macrovascular disease rates111–113.”

    From Epidemiology of type 1 diabetes (2010) · cites this paper as [109]

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Authors
Rewers, M.
Affiliations
University of Colorado Denver (US)
Corresponding author
Rewers, Marian
ORCID
Rewers, Marian
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2008-04-01
Volume
31
Issue
4
Pages
830-832
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc08-0245
OpenAlex
W2079280803
Semantic Scholar
53b9dc91041cb0a5573e6c19606901687aa943bd
Cited by
17
References
15
Citations by year
2021: 2 · 2016: 1 · 2015: 2 · 2012: 6
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
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 Treatment and Management
Keywords
diabetes mortality, cardiovascular mortality, type 1 diabetes, type 2 diabetes, sex differences in mortality, modifiable risk factors, survival predictors, life expectancy, women with diabetes
MeSH terms
Cardiovascular Diseases, Diabetes Mellitus, Type 1, Diabetic Angiopathies, Humans, Survival Analysis, Survivors

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