Mortality within the first 10 years of the disease in type 2 diabetic patients

被引:24
作者
Bo, S
Ciccone, G
Gancia, R
Rosato, R
Grassi, G
Merletti, F
Pagano, GF
机构
[1] Univ Turin, Dept Internal Med, I-10126 Turin, Italy
[2] S Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy
关键词
co-morbidity; diabetes duration; mortality; nephropathy; type; 2; diabetes;
D O I
10.1016/j.numecd.2005.01.003
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and aims: An excess of tong-term mortality in type 2 diabetes is mainly due to cardiac diseases, predicted by diabetes-related conditions; less is known about early death from clinical diagnosis. The aim of this study was to evaluate pattern and predictors of mortality after a 4.5 year follow-up in a cohort of type 2 diabetic patients, according to diabetes duration. Methods and results: A mortality follow-up was carried out in 1200 patients with :!,5 years diabetes duration and 2692 patients with > 5 (median 2 and 15) years diabetes duration in 1995. Four-year survival was 92.0% and 83.7%, respectively; most deaths are due to cardiovascular diseases (36% and 41%, respectively). The duration of diabetes is no longer a significant predictor of death after adjustments for age, HbA1c and chronic complications (which are all significantly higher in patients who have had diabetes for longer time). In a Cox proportional hazard model, best predictors of death are nephropathy, insulin therapy and pre-existent co-morbidity in both groups. Nephropathy is significantly associated with cardiovascular deaths in the younger cohort. Conclusion: Clinical nephropathy is a significant predictor of early and late mortality from clinical diagnosis, above all cardiovascular deaths, indicating that an aggressive approach should be adopted for prevention or treatment of renal impairment right from the clinical onset of diabetes. (c) 2005 Elsevier B.V. All rights reserved.
引用
收藏
页码:8 / 12
页数:5
相关论文
共 13 条
[1]   LONG-TERM GLYCEMIC CONTROL RELATES TO MORTALITY IN TYPE-II DIABETES [J].
ANDERSSON, DKG ;
SVARDSUDD, K .
DIABETES CARE, 1995, 18 (12) :1534-1543
[2]   RISK-FACTORS FOR EARLY DEATH IN NON-INSULIN-DEPENDENT DIABETES AND MEN WITH KNOWN GLUCOSE-TOLERANCE STATUS [J].
BALKAU, B ;
ESCHWEGE, E ;
PAPOZ, L ;
RICHARD, JL ;
CLAUDE, JR ;
WARNET, JM ;
DUCIMETIERE, P .
BRITISH MEDICAL JOURNAL, 1993, 307 (6899) :295-299
[3]   Diabetes duration and cause-specific mortality in the Verona Diabetes Study [J].
Brun, E ;
Nelson, RG ;
Bennett, PH ;
Imperatore, G ;
Zoppini, G ;
Verlato, G ;
Muggeo, M .
DIABETES CARE, 2000, 23 (08) :1119-1123
[4]   PROGNOSTIC VALUE OF URINARY ALBUMIN EXCRETION RATE AND OTHER RISK-FACTORS IN ELDERLY DIABETIC-PATIENTS AND NONDIABETIC CONTROL SUBJECTS SURVIVING THE 1ST 5 YEARS AFTER ASSESSMENT [J].
DAMSGAARD, EM ;
FROLAND, A ;
JORGENSEN, OD ;
MOGENSEN, CE .
DIABETOLOGIA, 1993, 36 (10) :1030-1036
[5]   Risk factors for cardiovascular mortality and morbidity: The WHO multinational study of vascular disease in diabetes. [J].
Fuller, JH ;
Stevens, LK ;
Wang, SL .
DIABETOLOGIA, 2001, 44 (Suppl 2) :S54-S64
[6]   Mortality and educational level among diabetic and non-diabetic population in the Turin Longitudinal Study: a 9-year follow-up [J].
Gnavi, R ;
Petrelli, A ;
Demaria, M ;
Spadea, T ;
Carta, Q ;
Costa, G .
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 2004, 33 (04) :864-871
[7]   CARDIOVASCULAR RISK-FACTORS IN CONFIRMED PREDIABETIC INDIVIDUALS - DOES THE CLOCK FOR CORONARY HEART-DISEASE START TICKING BEFORE THE ONSET OF CLINICAL DIABETES [J].
HAFFNER, SM ;
STERN, MP ;
HAZUDA, HP ;
MITCHELL, BD ;
PATTERSON, JK .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1990, 263 (21) :2893-2898
[8]   The impact of diabetes mellitus on mortality from all causes and coronary heart disease in women - 20 years of follow-up [J].
Hu, FB ;
Stampfer, MJ ;
Solomon, CG ;
Liu, SM ;
Willett, WC ;
Speizer, FE ;
Nathan, DM ;
Manson, JE .
ARCHIVES OF INTERNAL MEDICINE, 2001, 161 (14) :1717-1723
[9]   A PROSPECTIVE-STUDY OF MORTALITY AMONG MIDDLE-AGED DIABETIC-PATIENTS (THE LONDON COHORT OF THE WHO MULTINATIONAL STUDY OF VASCULAR-DISEASE IN DIABETICS) .2. ASSOCIATED RISK-FACTORS [J].
MORRISH, NJ ;
STEVENS, LK ;
HEAD, J ;
FULLER, JH ;
JARRETT, RJ ;
KEEN, H .
DIABETOLOGIA, 1990, 33 (09) :542-548
[10]   Evolution, risk factors, and prognostic implications of albuminuria in NIDDM [J].
Niskanen, LK ;
Penttila, I ;
Parviainen, M ;
Uusitupa, MIJ .
DIABETES CARE, 1996, 19 (05) :486-493