All-cause mortality and factors associated with it in Finnish patients with type 1 diabetes.

Autor: Putula E; Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland; Tampere University Hospital, Department of Internal Medicine, Tampere, Finland. Electronic address: elena.putula@tuni.fi., Kauppala T; Finnish Institute for Health and Welfare, THL, Finland., Vanhamäki S; Finnish Institute for Health and Welfare, THL, Finland., Haapakoski J; Finnish Institute for Health and Welfare, THL, Finland., Laatikainen T; Finnish Institute for Health and Welfare, THL, Finland; University of Eastern Finland, Faculty of Health Sciences, Finland., Metso S; Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland; Tampere University Hospital, Department of Internal Medicine, Tampere, Finland.
Jazyk: angličtina
Zdroj: Journal of diabetes and its complications [J Diabetes Complications] 2024 Dec; Vol. 38 (12), pp. 108881. Date of Electronic Publication: 2024 Oct 12.
DOI: 10.1016/j.jdiacomp.2024.108881
Abstrakt: Aims: To assess the effect of comorbidities, risk classification for chronic kidney disease (CKD) according to albuminuria and eGFR, HbA1c and LDL-cholesterol levels on all-cause mortality in patients with type 1 diabetes (DM1).
Methods: The study included all 45,801 DM1 patients from the Finnish Diabetes Registry during 2018-2022. Mortality of patients with DM1 was compared with mortality in non-diabetic population in Finland by estimating standardized mortality rates (SMRs). Poisson regression model was used to estimate the effect of risk factors on the SMR.
Results: A total of 2469 patients died during follow-up. SMR for the total cohort was 1.84 (95 % CI 1.77-1.92) peaking at the age of 30-49 years. The coverage of HbA1c values was 98 %, that of LDL-cholesterol 94 %, and U-ACR and eGFR 80 %. In a multivariate analysis, assessing the effect on mortality, the rate ratio for end-stage renal disease was 2.66, cardiovascular diseases 1.92, mental and behavioural disorders 1.64, foot complications 1.51, high or very high risk for CKD 3.64, LDL-cholesterol ≥2.6 mmol/l 1.33, and HbA1c ≥8 % (64 mmol/mol) 1.27.
Conclusions: There's substantial excess mortality due to DM1 in Finland. Interventions should focus on addressing both renal and cardiovascular risk factors but also pay more attention to mental health.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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