1603-P: Changes in Age- and Gender-Specific All-Cause Mortality Rates and Ratios in People with T2DM in Hungary between 2001-2016: A Nationwide Cohort Study

Abstract

T2DM is associated with a higher risk of all-cause mortality; however, detailed analyses of age- and gender-specific subgroups are rare. The aim of the study was to analyze the changes of age- and gender-specific all-cause mortality rates and ratios (excess risk) in T2DM subjects (aged >40 years) in Hungary between 2001 and 2016. We used the central database of the National Institute of Health Insurance Fund. Annual all-cause mortality rates and ratios (T2DM/non-T2DM) were determined in males/females and in different age-groups (41-50, 51-60, 61-70, >71 years). Age-adjusted values were used for evaluating standardized mortality rates. Among pharmacologically treated T2DM subjects we found 117,700 and 329,845 males, 232,143 and 391,382 females in 2001 and 2016, respectively. Standardized all-cause mortality rate was higher in males than females in 2001 (4540/100,000 vs. 3365/100,000) which decreased to 4125/100,000 in males (change: -11.8%, p<0.0001) and to 2977/100,000 in females (change: -9.2%; p=0.0558) in 2016. The standardized all-cause mortality ratio was higher in females (1.39) than in males (1.13) in 2001. We found a significant increase (8.35%; p=0.0272) in standardized mortality ratios in our cohort between 2001 and 2016 which was higher in males (11.44%; p=0.0096) than females (2.78%; p=0.3288). We observed the most pronounced increase in all-cause mortality ratios between 2001 and 2016 in age-groups of 41-50 and 51-60 years in both genders (change varied from 54.2% to 101.8%; p<0.05) which was due to distinct tendencies in changes of mortality curves (more impressive decrease in non-T2DM subjects than in T2DM patients). Pharmacologically treated T2DM subjects in lower age-groups (41-60 years) had the highest increase in all-cause mortality ratios between 2001 and 2016 in Hungary. These data indicate that younger patients with T2DM need special attention for improving long-term outcomes. Disclosure G. Jermendy: None. Z. Kiss: None. G. Rokszin: None. I. Fábián: None. I. Wittmann: None. P. Kempler: None. Funding Hungarian Diabetes Association (2019)