Mortality patterns in Dutch diabetes outpatients.

Autor: Bak JCG; Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands.; Dutch Institute for Clinical Auditing, Leiden, Netherlands., de Vries SAG; Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands.; Dutch Institute for Clinical Auditing, Leiden, Netherlands., Serné EH; Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands., Groenwold RHH; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands., de Valk HW; Department of Internal Medicine, University Medical Center Utrecht, Utrecht, Netherlands., Mul D; Diabeter, Center for Pediatric and Adult Diabetes Care and Research, Rotterdam, Netherlands., Sas TCJ; Diabeter, Center for Pediatric and Adult Diabetes Care and Research, Rotterdam, Netherlands.; Department of Pediatric Endocrinology, Erasmus Medical Center, Rotterdam, Netherlands., Bizino M; Department of Internal Medicine, Groene Hart Ziekenhuis, Gouda, The Netherlands., Nieuwdorp M; Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands., Kramer MHH; Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands., Verheugt CL; Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands.
Jazyk: angličtina
Zdroj: Diabetes, obesity & metabolism [Diabetes Obes Metab] 2024 Oct; Vol. 26 (10), pp. 4213-4224. Date of Electronic Publication: 2024 Jul 29.
DOI: 10.1111/dom.15750
Abstrakt: Aim: Diabetes mellitus is a major cause of death. Outpatients with diabetes have more complications than patients in general practice; mortality patterns have only been studied in the total diabetes population. This study aims to assess mortality, causes, and predictors in outpatients with diabetes.
Materials and Methods: A cohort study, included people with diabetes mellitus from the nationwide Dutch Paediatric and Adult Registry of Diabetes (DPARD) visiting diabetes outpatient clinics in 2016-2020. DPARD data were linked to Statistics Netherlands (CBS), comprising data on mortality, ethnicity and education. All-cause and cardiovascular mortality rates were estimated using Cox proportional hazard regression.
Results: During a median follow-up of 3.1 years among 12 992 people with diabetes, mortality rates per 10 000 person-years were 67.7 in adult type 1 diabetes and 324.2 in type 2 diabetes. The major cause of non-cardiovascular death was malignancy. During the pandemic years of influenza (2018) and COVID (2020), mortality rates peaked. Age, smoking and an estimated glomerular filtration rate of <60 ml/min were associated with all-cause mortality. In type 2 diabetes, additional factors were male sex, body mass index <20 kg/m 2 , diabetes duration <1 year and hypertension.
Conclusions: Mortality among Dutch outpatients with diabetes is high. Smoking and renal failure were associated with mortality in both types. Further focus on early detection and treatment of mortality-associated factors may improve clinical outcomes.
(© 2024 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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