Abstract
BackgroundStudies have shown that type 2 diabetic patients have higher all-cause mortality than people without diabetes, but it is less clear how diabetes affects mortality in elderly patients and to what degree mortality differs between diabetic men and women. The aim of the present study is to investigate the age- and sex-specific all-cause mortality pattern in patients with type 2 diabetes in comparison with the Danish background population.MethodsPopulation-based cohort study of 1323 patients, diagnosed with clinical type 2 diabetes in 1989-92 and followed for 16 years. Median (interquartile range) age at diagnosis was 65.3 (55.8-73.6) years. The age- and sex-specific hazard rates were estimated for the cohort using the life table method and compared with the expected hazard rates calculated with Danish register data from the general population.ResultsIn comparison with the general population, diabetic patients had a 1.5-2.5 fold higher risk of dying depending on age. The over-mortality was higher for men than for women. It decreased with age in both sexes, and among patients over 80 years at diagnosis the difference between the observed and the expected survival was small.ConclusionWe found an excess mortality of type 2 diabetic patients compared with the background population in all age groups. The excess mortality was most pronounced in men and in young patients.
Highlights
Studies have shown that type 2 diabetic patients have higher all-cause mortality than people without diabetes, but it is less clear how diabetes affects mortality in elderly patients and to what degree mortality differs between diabetic men and women
All doctors were to include all patients on their practice list fulfilling the following criteria: 1) diabetes mellitus diagnosed from 1 March 1989 to 28 February 1991 (71 GPs volunteered for a 1-year extension of this period to establish a large cohort of patients suitable for epidemiological research), 2) based on hyperglycaemic symptoms and/or raised blood glucose values measured in general practice, the diagnosis was established by a single fasting whole blood or plasma glucose concentration ≥7.0/8.0 mmol/l measured at a major laboratory, and 3) age 40 years or older at diagnosis
The excess mortality in men compared with woman was seen in all age groups (Table 2) and seems fairly constant over time after diagnosis (Fig. 1)
Summary
Studies have shown that type 2 diabetic patients have higher all-cause mortality than people without diabetes, but it is less clear how diabetes affects mortality in elderly patients and to what degree mortality differs between diabetic men and women. The aim of the present study is to investigate the age- and sex-specific all-cause mortality pattern in patients with type 2 diabetes in comparison with the Danish background population. Found no increased mortality in patients over 70 years of age irrespective of sex [5] or in elderly male patients [2,3,15] or elderly female patients [10] This may partly be explained by short follow-up times and few participants which may reflect lack of power to detect a real effect of patient's sex and age on mortality [2,5,10,15]. The aim of the present study was to investigate the mortality patterns over the first 16 years after diabetes diagnosis in comparison with the general Danish population, and to assess the influence of age and sex
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