open access
Mortality trends in type 1 diabetes
open access
Abstract
RESEARCH DESIGN AND METHODS. Overall, sex- and race-specific mortality rates per person-year of follow- up were determined. Standardized mortality ratios were also calculated. Survival analyses and Cox proportional hazard model were also used. Temporal trends were examined by dividing the cohort into three groups by year of diagnosis (19651969, 19701974, and 19751979).
RESULTS. Living status of 972 cases was ascertained as of January 1, 1999 (ascertainment rate 90.4%). The mean duration of diabetes was 25.2 65.8 (SD) years. Overall, 170 deaths were observed. The crude mortality rate was 627 per 100,000 person- years (95% CI 532728) and standardized mortality ratio was 519 (440602). Life-table analyses by the Kaplan-Meier method indicated cumulative survival rates of 98.0% at 10 years, 92.1% at 20 years, and 79.6% at 30 years duration of diabetes. There was a significant improvement in the survival rate between the cohort diagnosed during 19651969 and that diagnosed during 19751979 by the log-rank test (P = 0.03). Mortality was higher in African-Americans than in Caucasians, but there were no differences seen by sex. The improvement in recent years was seen in both ethnic groups and sexes.
CONCLUSIONS. An improvement in long-term survival was observed in the more re-cently diagnosed cohort. This improvement is consistent with the introduction of HbA1 testing, home blood glucose monitoring, and improved blood pressure therapy in the 1980s.
Abstract
RESEARCH DESIGN AND METHODS. Overall, sex- and race-specific mortality rates per person-year of follow- up were determined. Standardized mortality ratios were also calculated. Survival analyses and Cox proportional hazard model were also used. Temporal trends were examined by dividing the cohort into three groups by year of diagnosis (19651969, 19701974, and 19751979).
RESULTS. Living status of 972 cases was ascertained as of January 1, 1999 (ascertainment rate 90.4%). The mean duration of diabetes was 25.2 65.8 (SD) years. Overall, 170 deaths were observed. The crude mortality rate was 627 per 100,000 person- years (95% CI 532728) and standardized mortality ratio was 519 (440602). Life-table analyses by the Kaplan-Meier method indicated cumulative survival rates of 98.0% at 10 years, 92.1% at 20 years, and 79.6% at 30 years duration of diabetes. There was a significant improvement in the survival rate between the cohort diagnosed during 19651969 and that diagnosed during 19751979 by the log-rank test (P = 0.03). Mortality was higher in African-Americans than in Caucasians, but there were no differences seen by sex. The improvement in recent years was seen in both ethnic groups and sexes.
CONCLUSIONS. An improvement in long-term survival was observed in the more re-cently diagnosed cohort. This improvement is consistent with the introduction of HbA1 testing, home blood glucose monitoring, and improved blood pressure therapy in the 1980s.
Keywords
type 1 diabetes; mortiality rates; blood glucose monitoring; blood pressure control


Title
Mortality trends in type 1 diabetes
Journal
Issue
Vol 2, No 3 (2001): Practical Diabetology
Pages
229-236
Published online
2001-06-15
Bibliographic record
Diabetologia Praktyczna 2001;2(3):229-236.
Keywords
type 1 diabetes
mortiality rates
blood glucose monitoring
blood pressure control
Authors
Rimei Nishimura
Ronald E. LaPorte
Janice S. Dorman
Naoko Tajima
Dorothy Becker
Trevor J. Orchard