Psychosocial and Socioeconomic Risk Factors for Premature Death in Young People With Type 1 Diabetes
| Autor: | Andrew C Burden, Anthony J. Swerdlow, Michael Jones, W. Gatling, Susan P. Laing |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Substance-Related Disorders Endocrinology Diabetes and Metabolism Reference Values Risk Factors Cause of Death Diabetes mellitus Epidemiology Internal Medicine medicine Humans Psychology Age of Onset Risk factor Young adult Child Aged Advanced and Specialized Nursing Type 1 diabetes business.industry Mental Disorders Smoking Odds ratio Middle Aged medicine.disease United Kingdom Diabetes Mellitus Type 1 Socioeconomic Factors Case-Control Studies Cohort Female business Psychosocial |
| Zdroj: | Diabetes Care. 28:1618-1623 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/diacare.28.7.1618 |
| Popis: | OBJECTIVE—Mortality from acute diabetes-related events is greatly raised in young adults with type 1 diabetes. Psychosocial and socioeconomic risk factors are examined for deaths from acute events separately from deaths due to other causes. RESEARCH DESIGN AND METHODS—This study had a nested case-control design. The cases were patients from the Diabetes UK cohort who died before age 40 years. Deaths were categorized as acute events or chronic conditions related to diabetes. Where possible, two matched control subjects were selected for each case. Data relating to psychosocial and socioeconomic factors and variables related to diabetes complications were extracted from the case notes. Risks of death were estimated by calculation of odds ratios (ORs). RESULTS—Case notes were obtained for 98 case and 137 control subjects. Fifty-one deaths were attributed to acute causes, 34 to chronic conditions related to diabetes, and the remaining 13 were unrelated to diabetes. Living alone (OR 4.4), past drug abuse (5.7), and previous psychiatric referral (4.6) were all significantly associated with death from acute events but not death from chronic conditions. There was no association between deaths from acute events and nephropathy, hypertension, neuropathy, or retinopathy, although all of these were associated with deaths from chronic conditions. CONCLUSIONS—The results indicate that psychosocial factors are powerful risk factors for mortality from acute events in patients with type 1 diabetes, although not for mortality from chronic conditions. The data enable the identification of a high-risk group suitable for targeting with preventive measures to reduce acute event mortality. |
| Databáze: | OpenAIRE |
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