The summary of the study was published as an article on medRxiv.org. It was not peer reviewed.
The most important takeaways
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The mortality rate for UK residents suffering from type2 diabetes was significantly higher than that of people who do not have diabetes. The risk of developing diabetes increased with the age.
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The risk of dying from type 2 diabetes was the same across all birth cohorts that were studied and demonstrates that there has been no improvement over time in reducing the chance of dying from type 2 diabetes.
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Pre-existing medical conditions, including untreated hypertension and smoking, increase the risk of dying. This effect is more evident in the later birth cohorts.
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Prescription of antihypertensive or antihypercholesterolemia drugs was linked with improved survival.
Why This Matters
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In the UK there hasn’t been much research done on the effect of type 2 diabetes and all-cause death in comparison to people without diabetes.
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There isn’t a single study that examined the impact of age on mortality in the case of type 2 diabetes.
Study Design
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The study involved 221,182 patients in Health Improvement Network. This is an UK primary care database which in 2017 contained medical records of 15.6 Million people, collected from 711 general physicians.
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The total number of participants was 68,199 people with type 2 diabetes who were chose because they were born between 1930 and 1960 inclusively and were diagnosed with type 2 diabetes between 2000 and 2016 inclusive when they were at least 50 years old. of age. The group was not able to include people who have a history of comorbidities, including stroke, cognitive impairment, cancer, or chronic kidney disease.
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Researchers matched each patient with three people from the control database without type 2 diabetes to form a cohort of 152 983 people.
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The analysis broke the population into three subgroups according to their birth year 1930-1939, 1940-1949 and 1950-1959.
Key Results
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Overall, people with type 2 diabetes had an average 38% higher mortality rate compared with people who did not have diabetes.
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Age was a factor in relative risk. Type 2 diabetics aged between 60 and 74 had an adjusted 52% higher mortality rate compared with similar-aged people who did not have diabetes. Between 50 and 59 years old the risk of dying from diabetes increased by 21% relative to those without diabetes. These relative hazard rates remained the same across the three birth cohorts.
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The hazard of death for males was 38% higher than that for women. Obesity was associated with significantly with a rise of 16% in mortality, however it was not significantly different than normal weight.
Limitations
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While the study was adjusted for possible confounding variables, there were not enough variables to cover all possible confounding factors. There could also be residual confounding due to insufficient data such as lifestyle changes, smoking intensity, or therapy modifications.
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Other significant variables that were that were not considered in the analytic models were ethnicity, antidiabetic drug use and A1c values.
Disclosures
This is a summary of a research study that was published as a preprint, “On the Survival of Individuals Diagnosed With Type 2 Diabetes Mellitus in the United Kingdom: A Retrospective Matched Cohort Study,” written by a team of researchers from the University of East Anglia in Norwich, UK, published on medRxiv, and distributed to you by Medscape. This study has not yet been peer reviewed. The full text of the study is available on medRxiv.org.
Mitchel L. Zoler is an editor for Medscape and MDedge based in the Philadelphia area. @mitchelzoler
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