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Mortality during 25 years of follow-up of a cohort with diabetes.
Int J Epidemiol. 1996 Dec; 25(6):1250-61.IJ

Abstract

BACKGROUND

Diabetes is one of the most common chronic diseases in Western populations. There have been few large published cohort studies of people with diabetes that have had more than 10 years of follow-up, and none other than the present one are in the UK. Such studies are important to understand the long-term fatal consequences of diabetes and their variation over time and between countries.

METHODS

Cause-specific mortality was analysed in follow-up from 1966-1970 to December 1992 of 5783 members of the British Diabetic Association living in England and Wales during 1966-1970. Comparison was made with age-, sex- and calendar year-specific mortality by cause in the general population of England and Wales.

RESULTS

During the follow-up 3399 (58.8%) subjects died. The relative risk of all-cause mortality in the cohort compared to the general population was 2.31 in women and 1.58 in men (both P < 0.001).Relative risks were greater for women than men at almost all ages and for each major diabetes-related cause of death. Absolute excess ('attributable') mortality rates were also greater in women than in men, except at ages < 50. Half the deaths in each sex were from circulatory diseases and only 3.4% were from renal disease. The relative risks of mortality for all-causes and circulatory diseases were particularly great at younger ages, but changed little with duration of follow-up. At ages < 40 the relative risks for all-causes were 3.75 in men and 5.51 in women and for ischaemic heart disease were 10.44 and 25.25 respectively (all P < 0.001). At these ages one-third of deaths were due to acute complications of diabetes, suicides and accidents, whereas at older ages these accounted for only 4% of deaths.

CONCLUSIONS

The mortality rates at young ages in the cohort were around twice those in Sweden, Norway and Israel, suggesting that many of the deaths in England and Wales are preventable. The results also indicate a particular need for investigation and amelioration of cardiovascular risk factors in English and Welsh patients, especially women.

Authors+Show Affiliations

Epidemiological Monitoring Unit, London School of Hygiene & Tropical Medicine, UK.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9027532

Citation

Swerdlow, A J., and M E. Jones. "Mortality During 25 Years of Follow-up of a Cohort With Diabetes." International Journal of Epidemiology, vol. 25, no. 6, 1996, pp. 1250-61.
Swerdlow AJ, Jones ME. Mortality during 25 years of follow-up of a cohort with diabetes. Int J Epidemiol. 1996;25(6):1250-61.
Swerdlow, A. J., & Jones, M. E. (1996). Mortality during 25 years of follow-up of a cohort with diabetes. International Journal of Epidemiology, 25(6), 1250-61.
Swerdlow AJ, Jones ME. Mortality During 25 Years of Follow-up of a Cohort With Diabetes. Int J Epidemiol. 1996;25(6):1250-61. PubMed PMID: 9027532.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mortality during 25 years of follow-up of a cohort with diabetes. AU - Swerdlow,A J, AU - Jones,M E, PY - 1996/12/1/pubmed PY - 1996/12/1/medline PY - 1996/12/1/entrez SP - 1250 EP - 61 JF - International journal of epidemiology JO - Int J Epidemiol VL - 25 IS - 6 N2 - BACKGROUND: Diabetes is one of the most common chronic diseases in Western populations. There have been few large published cohort studies of people with diabetes that have had more than 10 years of follow-up, and none other than the present one are in the UK. Such studies are important to understand the long-term fatal consequences of diabetes and their variation over time and between countries. METHODS: Cause-specific mortality was analysed in follow-up from 1966-1970 to December 1992 of 5783 members of the British Diabetic Association living in England and Wales during 1966-1970. Comparison was made with age-, sex- and calendar year-specific mortality by cause in the general population of England and Wales. RESULTS: During the follow-up 3399 (58.8%) subjects died. The relative risk of all-cause mortality in the cohort compared to the general population was 2.31 in women and 1.58 in men (both P < 0.001).Relative risks were greater for women than men at almost all ages and for each major diabetes-related cause of death. Absolute excess ('attributable') mortality rates were also greater in women than in men, except at ages < 50. Half the deaths in each sex were from circulatory diseases and only 3.4% were from renal disease. The relative risks of mortality for all-causes and circulatory diseases were particularly great at younger ages, but changed little with duration of follow-up. At ages < 40 the relative risks for all-causes were 3.75 in men and 5.51 in women and for ischaemic heart disease were 10.44 and 25.25 respectively (all P < 0.001). At these ages one-third of deaths were due to acute complications of diabetes, suicides and accidents, whereas at older ages these accounted for only 4% of deaths. CONCLUSIONS: The mortality rates at young ages in the cohort were around twice those in Sweden, Norway and Israel, suggesting that many of the deaths in England and Wales are preventable. The results also indicate a particular need for investigation and amelioration of cardiovascular risk factors in English and Welsh patients, especially women. SN - 0300-5771 UR - https://www.unboundmedicine.com/medline/citation/9027532/Mortality_during_25_years_of_follow_up_of_a_cohort_with_diabetes_ L2 - https://academic.oup.com/ije/article-lookup/doi/10.1093/ije/25.6.1250 DB - PRIME DP - Unbound Medicine ER -