Age-specific trends from 2000-2011 in all-cause and cause-specific mortality in type 1 and type 2 Diabetes: A cohort study of more than one million people

Jessica L. Harding, Jonathan E. Shaw, Anna Peeters, Susan Davidson, Dianna J. Magliano

Research output: Contribution to journalArticleResearchpeer-review

35 Citations (Scopus)

Abstract

OBJECTIVE To analyze changes by age-group in all-cause and cause-specific mortality rates from 2000-2011 in people with diabetes. 

RESEARCH DESIGN AND METHODS A total of 1,189,079 (7.3% with type 1 diabetes) Australians with diabetes registered on the National Diabetes Service Scheme between 2000 and 2011 were linked to the National Death Index. Mortality rates in the total population were age standardized to the 2001 Australian population. Mortality rates were calculated for the following age-groups: 0 to <40 years, ≥40 to <60 years, and ≥60 to ≤85 years. Annual mortality rates were fitted using a Poisson regression model including calendar year as a covariate and age and sex where appropriate, with Ptrend reported. RESULTS For type 1 diabetes, all-cause, cardiovascular disease (CVD), and diabetes age standardized mortality rates (ASMRs) decreased each year by 0.61, 0.35, and 0.14 per 1,000 person-years (PY), respectively, between 2000 and 2011, Ptrend < 0.05, while cancer mortality remained unchanged. By age, significant decreases in all cause, CVD, and diabetes mortality rates were observed in all age-groups, excluding diabetes mortality in age-group 0-40 years. For type 2 diabetes, all-cause, CVD, and diabetes ASMRs decreased per year by 0.18, 0.15, and 0.03 per 1,000 PY, respectively, Ptrend < 0.001, while cancer remained unchanged. By age, these decreases were observed in all age-groups, excluding 0-40 years, where significant increases in all-cause and cancer mortality were noted and no change was seen for CVD and diabetes mortality. 

CONCLUSIONS All-cause, CVD, and diabetes ASMRs in type 1 and type 2 diabetes decreased between 2000 and 2011, while cancer ASMRs remained unchanged. However, younger populations are not benefiting from the same improvements as older populations. In addition, the absence of a decline in cancer mortality warrants urgent attention.

Original languageEnglish
Pages (from-to)1018-1026
Number of pages9
JournalDiabetes Care
Volume39
Issue number12
DOIs
Publication statusPublished - Jun 2016

Cite this