1468-P: Cause-Specific Mortality over 30 Years among Chinese with Newly Diagnosed Diabetes: The Da Qing IGT and Diabetes Study

Abstract

Despite its growing prevalence in China, the extent to which diabetes leads to excess mortality and its underlying causes are ill-defined. Six-hundred and six persons with newly diagnosed diabetes (NDD) and a comparison group of 494 with normal glucose tolerance (NGT) were identified in 1986 by screening 110,660 adults aged 25-74 years who agreed to participate in The Da Qing IGT and Diabetes study. A follow-up study of the original study participants was conducted in 2016. We compared death rates and causes of death between the two groups during 30 years of follow-up. Four-hundred and forty (71.7%) participants with NDD and 153 (31.0%) with NGT died. Overall mortality (rates/1,000 person-years + 95% CI) were much higher in those with NDD than with NGT, 40.8 (35.6-46.5) vs.15.8 (13.0-19.1) in men (P< 0.0001), and 30.4 (26.4-34.9) vs. 6.9 (5.0-9.3) in women (P<0.0001). Earlier age at diagnosis of diabetes was significantly related to the relative risk of death (RR (+95% CI)), 5.0 (2.9-8.6) in those diagnosed at age 25∼39y, 3.2 (2.3-4.4)] at 40∼49y, and 2.8 (2.1-3.6) at 50∼74y. Cardiovascular disease (CVD) was the predominant cause of death in those with diabetes (66.5% in men and 62.8% in women), almost half of which was due to stroke (52.1% in men and 40.6% in women). After age-sex adjustment, the NDDs had significant increased mortality from CVD (RR 3.9 [95% CI, 2.9-5.2]), renal failure (RR 15.6 [95% CI, 6.3-38.9]), infection (RR 4.2 [95% CI, 2.0-8.5]), and cancer (RR 1.5 [95% CI, 1.0-2.3]). In conclusion, diabetes is associated with substantially increased risks of death in Chinese adults, especially from CVD, renal failure, infection and cancer. Earlier age at diagnosis leads to greater relative risk of death. Disclosure Y. An: None. P. Zhang: None. J. Wang: None. Q. Gong: None. B. Zhang: None. Y. Chen: None. E. Gregg: None. P.H. Bennett: Consultant; Self; World Health Organization. Stock/Shareholder; Self; Becton, Dickinson and Company, Eli Lilly and Company, Pfizer Inc., UnitedHealth Group Inc. Other Relationship; Self; American Diabetes Association, Centers for Disease Control and Prevention, European Association for the Study of Diabetes, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. G. Li: None. Funding Centers for Disease Control and Prevention/Chinese Center for Disease Control and Prevention (5U19GH000636-05)