All-cause mortality in a nationwide cohort of childhood-onset diabetes in Norway 1973-2013

作者：Gagnum Vibeke^*; Stene Lars C; Sandvik Leiv; Fagerland Morten W; Njolstad Pal R; Joner Geir; Skrivarhaug Torild

来源：Diabetologia, 2015, 58(8): 1779-1786.

DOI：10.1007/s00125-015-3623-7

• Childhood-onset diabetes
• Cohort study
• Mortality
• Type 1 diabetes

Aims/hypothesis The aim of this study was to assess the association between all-cause mortality and sex, age at diagnosis and year of diagnosis in Norwegian patients with childhood-onset diabetes.
Methods The study was based on the nationwide, population-based Norwegian Childhood Diabetes Registry, which includes all newly diagnosed cases of childhood-onset diabetes at age 0-14 years in 1973-1982 and 1989-2012 (n=7,884). Patients were followed until date of death, emigration or 30 September 2013.
Results Among the 7,884 patients, representing 132,420 person-years, 249 (3.2%) died during a mean follow-up of 16.8 (range 0.0-40.7) years. The standardised mortality ratio (SMR) for the total cohort was 3.6 (95% CI 3.1, 4.0), increasing by attained age. Absolute mortality was significantly lower in females than in males (HR 0.50 [95% CI 0.38, 0.65]), although the SMRs were similar. Cox regression analysis showed a significant decrease in mortality of 49% (HR 0.51 [ 95% CI 0.28, 0.93]) for those diagnosed in 1999-2012 compared with those diagnosed in 1973-1982 (p=0.03).
Conclusions/interpretation In spite of improved diabetes care, mortality is still three to four times higher in those with childhood-onset diabetes compared with the general population in Norway. However, absolute mortality has declined among children diagnosed most recently (1999-2012) compared with those diagnosed in the earliest period (1973-1982).

• 出版日期2015-8