科研之友
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摘要
OBJECTIVE - Although management of type 1 diabetes improved dramatically in the 1980s the effect on mortality is not clear
RESEARCH DESIGN AND METHODS - We report trends in 30-year mortality using the Allegheny County (Pennsylvania) childhood onset (age <18 years) type 1 diabetes registry (n = 1 075) with diagnosis from 1965-1979 by dividing the cohort into three diagnosis year cohorts (1965-1969, 1970-1974 and 1975-1979) Local (Allegheny County) mortality data were used to calculate standardized mortality ratio c (SMRs)
RESULTS - As of 1 January 2008 vital status was ascertained for 97 0% of participants (n = 1 043) when mean age +/- SD and duration of diabetes were 42 8 +/- 8 0 and 32 0 +/- 7 6 years respectively The 279 deaths (26 0%) observed were 7 times higher than expected (SMR 6 9 [95% CI 6 1-7 7]) An improving trend in SMR A as seen by diagnosis cohort at 30 years of diabetes duration (9 3 [7 2-11 3] 7 5 [5 8-9 2] and 5 6 [4 0-7 2] for 1965-1969 1970-1974 and 1975-1979 respectively) Although no sex difference in survival was observed (P = 0 27) female diabetic patients were 13 times more likely to die than age-matched women in the general population (SMR 13 2 [10 7-15 7]) much higher than the SMR for men (5 0 [4 0-6 0]) Conversely whereas 30-year survival was significantly lower in African Americans than in Caucasians (57 2 vs 82 7% respectively P < 0 00]) no differences in SMR were seen by race
CONCLUSIONS - Although survival has clearly improved those with diabetes diagnosed most recently (1975-1979) still had a mortality rate 5 6 times higher than that seen in the general population revealing a continuing need for improvements in treatment and care particularly for women and African Americans with type 1 diabetes
- 出版日期2010-12
