FRIDAY, Sept. 9 (HealthDay News) -- For patients with early-onset type 1 diabetes survival has increased over time, but survival for individuals with late-onset type 1 diabetes has decreased since the 1980s, according to a study published online Sept. 8 in BMJ.
Valma Harjutsalo, Ph.D., from Biomedicum Helsinki in Finland, and colleagues investigated mortality trends and causes of death over time in 17,306 Finnish patients diagnosed with type 1 diabetes. Participants were classified as having early-onset (between zero and 14 years) and late-onset (between 15 and 29 years) diabetes. The main outcome measures were crude mortality, standardized mortality ratios, time trends, and cumulative mortality.
The investigators identified 1,338 deaths during 370,733 person years of follow-up, yielding an all-cause mortality rate of 361 per 100,000 person years. The standardized mortality ratio in the early- and late-onset cohorts was 3.6 and 2.8, respectively. The standardized mortality ratios were higher for women than for men in both cohorts (early-onset, 5.5 versus 3.0, respectively; late-onset, 3.6 versus 2.6, respectively). The standardized mortality ratio at 20 years' duration of diabetes in the early-onset cohort was 3.5 and 1.5 in patients diagnosed in 1970 to 1974 and 1985 to 1989, respectively. In the late-onset cohort, it was 1.4 and 2.9 for those diagnosed in 1970 to 1974 and 1985 to 1989, respectively. In the early-onset cohort, there was a decrease in mortality due to chronic complications of diabetes over time, whereas in the late-onset cohort, alcohol and drug-related mortality and mortality due to acute complications of diabetes increased significantly.
"Survival of people with early-onset type 1 diabetes has improved over time, whereas survival of people with late-onset type 1 diabetes has deteriorated since the 1980s," the authors write.
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