Mortality Risk in Adults With and Without Type 2 Diabetes after 18 Years of Follow-up in Northern Spain—The Asturias Study

Abstract

Objective: People who develop type 2 diabetes (T2D) have higher mortality risk. Regarding Asturias Study, after 18 years of follow-up, we have estimated all-cause, cardiovascular and cancer mortality-risks according to categories of impaired glucose metabolism. Research Design and Methods: Asturias study (launched in 1998) included a mortality follow-up of 18 years of its regionwide sample representative of population aged 30-75 years. Age and sex- stratified hazard ratios (HR) were calculated for 48 participants with diagnosed T2D (self reported diagnosis or antidiabetic medication), 83 with undiagnosed T2D (no diagnosed T2D, glycated hemoglobin A1c ≥6,5%, fasting glycemia≥126 mg/dL or glycemia after 75g glucose load ≥200 mg/dL), 296 with prediabetes (glycated hemoglobin A1c 5,7-6,4%, fasting glycemia 100-125 mg/dL or glycemia after 75g glucose load 140-199 mg/dL) and 607 with normoglycemia. Results: Over 18,612 person-years, 204 people died (32 with undiagnosed T2D, 30 with diagnosed T2D, 62 with prediabetes and 80 with normoglycemia). HR for all cause mortality, adjusted by previous cardiovascular disease, history of high blood pressure, LDL cholesterol level, age, sex, BMI and estimate glomerular filtration rate, was 2.22 (1.42-3.48) for diagnosed T2D, 1.57 (1.03-2.39) for undiagnosed diabetes. Adjusted hazard ratio for cardiovascular mortality was 3.12 (1.55-6.29) for diagnosed T2D and, for cancer mortality, was 1.83 (0.79-4.22) vs. normoglycemia. Women with T2D have higher age-standarized cardiovascular-mortality risk than men with T2D (7.36 (2,84-19.09) vs. 1.58 (1.45-5.56)). People with prediabetes have similar mortality risks as people with normoglycemia. Conclusions: In Asturias, age and sex-standardized all-cause mortality is more than two times higher for adults with T2D than for adults without T2D. HR for cardiovascular mortality is highly increased in women with T2D comparing with men with the same condition. Disclosure J. Ares: Research Support; Self; Sanofi. S. Valdes: None. P. Botas: None. C. Sánchez-Ragnarsson: None. E. Menéndez-Torre: Speaker's Bureau; Self; Sanofi, AstraZeneca, Novo Nordisk A/S. E. Delgado: Advisory Panel; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca, Novo Nordisk A/S. Advisory Panel; Self; Sanofi-Aventis. Speaker's Bureau; Self; Sanofi-Aventis. Research Support; Self; Sanofi-Aventis. Speaker's Bureau; Self; Esteve, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Abbott. Speaker's Bureau; Self; Lilly. Research Support; Self; Menarini Group.