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Why Do People With Diabetes Die Too Soon?

More questions than answers

From the Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado

Address correspondence and reprint requests to Barbara Davis, Center for Childhood Diabetes, University of Colorado Denver, School of Medicine, Mail Stop A-140, P.O. Box 6511, Aurora CO, 80045-6511. E-mail: marian.rewers@uchsc.edu

The first 300 words of the full text of this article appear below.

The excess mortality among people with diabetes and the role of cardiovascular disease (CVD) in shortening their lives have been recognized for decades (1–3). Recent studies suggest that all-cause mortality (4) and CVD incidence among people with diabetes (5) are declining; however, the proportion of CVD attributable to diabetes has increased over the past 50 years, largely due to the increase in diabetes prevalence (6). Furthermore, mortality follow-up of the National Health and Nutrition Examination Survey (NHANES) I, II, and III participants may suggest that despite some progress in reducing mortality in men with diabetes, women are still at a greatly increased risk (7). The vital question for an estimated 200 million people with diabetes worldwide today (8) is what to do to improve life expectancy and quality.

A study from Finland in this issue of Diabetes Care by Juutilainen et al. (9) attempts to shed some light on modifiable determinants of survival among patients diagnosed with diabetes after age 30 years. In a cohort of 173 type 1 and 834 type 2 diabetic patients followed for 18 years, the total mortality risk was increased threefold and CVD mortality was increased fivefold compared with the general population, confirming previous studies. The comparisons were adjusted for age, sex, duration of diabetes, area of residence, BMI, blood pressure, total and HDL cholesterol, proteinuria, creatinine clearance, smoking, and alcohol intake measured at baseline. Consistent with many previous reports, the increase in CVD mortality risk was much more dramatic in diabetic women (11- to 13-fold) than in diabetic men (3- to 4-fold) compared with the general population. The increase in total mortality risk was less pronounced: 4.5-fold in women and 2-fold in men, respectively.

The novel finding appears . . . [Full Text of this Article]

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Similarity of the Impact of Type 1 and Type 2 Diabetes on Cardiovascular Mortality in Middle-Aged Subjects

Auni Juutilainen, Seppo Lehto, Tapani Rönnemaa, Kalevi Pyörälä, and Markku Laakso
Diabetes Care 2008 31: 714-719. [Abstract] [Full Text] [PDF]