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All-cause mortality in a nationwide cohort of childhood-onset diabetes in Norway 1973–2013

2015; Springer Science+Business Media; Volume: 58; Issue: 8 Linguagem: Inglês

10.1007/s00125-015-3623-7

1432-0428

Vibeke Gagnum, Lars C. Stene, Leiv Sandvik, Morten Wang Fagerland, Pål R. Njølstad, Geir Joner, Torild Skrivarhaug,

Hyperglycemia and glycemic control in critically ill and hospitalized patients

The aim of this study was to assess the association between all-cause mortality and sex, age at diagnosis and year of diagnosis in Norwegian patients with childhood-onset diabetes. The study was based on the nationwide, population-based Norwegian Childhood Diabetes Registry, which includes all newly diagnosed cases of childhood-onset diabetes at age 0–14 years in 1973–1982 and 1989–2012 (n = 7,884). Patients were followed until date of death, emigration or 30 September 2013. Among the 7,884 patients, representing 132,420 person-years, 249 (3.2%) died during a mean follow-up of 16.8 (range 0.0–40.7) years. The standardised mortality ratio (SMR) for the total cohort was 3.6 (95% CI 3.1, 4.0), increasing by attained age. Absolute mortality was significantly lower in females than in males (HR 0.50 [95% CI 0.38, 0.65]), although the SMRs were similar. Cox regression analysis showed a significant decrease in mortality of 49% (HR 0.51 [95% CI 0.28, 0.93]) for those diagnosed in 1999–2012 compared with those diagnosed in 1973–1982 (p = 0.03). In spite of improved diabetes care, mortality is still three to four times higher in those with childhood-onset diabetes compared with the general population in Norway. However, absolute mortality has declined among children diagnosed most recently (1999–2012) compared with those diagnosed in the earliest period (1973–1982).