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Long-Term Mortality in Nationwide Cohorts of Childhood-Onset Type 1 Diabetes in Japan and Finland
Open accessAbstract
OBJECTIVE—This study compares mortality from type 1 diabetes in Japan and Finland and examines the effects of sex, age at diagnosis, and calendar time period of diagnosis on mortality. RESEARCH DESIGN AND METHODS—Patients with type 1 diabetes from Japan (n = 1,408) and Finland (n = 5,126), diagnosed from 1965 through 1979, at age <18 years, were followed until 1994. Mortality was estimated with and without adjustment for that of the general population to assess absolute and relative mortality using Cox proportional hazard models. RESULTS—Overall mortality rates in Japan and Finland were 607 (95% CI 510–718) and 352 (315–393), respectively, per 100,000 person-years; standardized mortality ratios were 12.9 (10.8–15.3) and 3.7 (3.3–4.1), respectively. Absolute mortality was higher for men than for women in Finland, but relative mortality was higher for women than for men in both cohorts. Absolute mortality was higher in both cohorts among those whose diabetes was diagnosed during puberty, but relative mortality did not show any significant difference by age at diagnosis in either cohort. In Japan, both absolute and relative mortality were higher among those whose diagnosis was in the 1960s rather than the 1970s. CONCLUSIONS—Mortality from type 1 diabetes was higher in Japan compared with Finland. The increased risk of death from type 1 diabetes seems to vary by sex, age at diagnosis, and calendar time period of diagnosis. Further investigation, especially on cause-specific mortality, is warranted in the two countries.
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Metadata
- Authors
- Asao, K., Sarti, C., Forsen, T., Hyttinen, V., Nishimura, R., Matsushima, M., Reunanen, A., Tuomilehto, J., Tajima, N., & for the Diabetes Epidemiology Research International (DERI) Mortality Study Group
- Affiliations
- Jikei University School of Medicine (JP)
- Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
- Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland
- University of Helsinki (FI)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2003-07-01
- Volume
- 26
- Issue
- 7
- Pages
- 2037-2042
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3752687
- OpenAlex
- W2121029363
- Cited by
- 102
- References
- 42
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 7 · 2023: 3 · 2022: 3 · 2021: 1 · 2020: 4 · 2019: 2 · 2018: 5 · 2017: 3 · 2016: 6 · 2015: 7 · 2014: 11 · 2013: 3 · 2012: 3
- FWCI
- 1.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Funders
- World Health Organization
- Novo Nordisk
- Novo Nordisk Fonden
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK035905)
- 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, long-term mortality, sex differences, age at diagnosis, Japan, Finland, standardized mortality ratio, cause-specific mortality
- MeSH terms
- Child, Diabetes Mellitus, Type 1, Female, Finland, Humans, Japan, Male, Probability, Sex Characteristics, Cohort Studies, Survival Analysis, Age of Onset
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