Relationship Between Risk Factors and Mortality in Type 1 Diabetic Patients in Europe

The EURODIAB Prospective Complications Study (PCS)

  1. Sabita S. Soedamah-Muthu, PHD12,
  2. Nish Chaturvedi, MD3,
  3. Daniel R. Witte, PHD2,
  4. Lynda K. Stevens, MSC2,
  5. Massimo Porta, MD4,
  6. John H. Fuller, FRCP2 and
  7. for the EURODIAB Prospective Complications Study Group
  1. 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
  2. 2Epidemiology and Public Health, Royal Free and University College London Medical School, London, U.K.
  3. 3National Heart and Lung Institute, Imperial College, London, U.K.
  4. 4Medicine, University of Turin, Turin, Italy
  1. Corresponding author: S.S. Soedamah-Muthu, s.s.soedamah-muthu{at}umcutrecht.nl

Abstract

OBJECTIVE—The purpose of this study was to examine risk factors for mortality in patients with type 1 diabetes.

RESEARCH DESIGN AND METHODS—Baseline risk factors were measured in the EURODIAB Prospective Cohort Study with 2,787 type 1 diabetic patients (51% men and 49% women) recruited from 16 European countries. Mortality data were collected during a 7-year follow-up.

RESULTS—There was an annual mortality rate of 5 per 1,000 person-years in patients with type 1 diabetes (mean age at baseline 33 years, range 15–61 years); of the total 2,787 subjects, 102 died. The final multivariable model contained age at baseline (standardized hazard ratio 1.78 [95% CI 1.44–2.20]), A1C (1.18 [0.95–1.46]), waist-to-hip ratio (WHR) (1.32 [1.14–1.52]), pulse pressure (1.33 [1.13–1.58]), and non-HDL cholesterol (1.33 [1.12–1.60]) as risk factors for all-cause mortality. Macroalbuminuria (2.39 [1.19–4.78]) and peripheral (1.88 [1.06–3.35]) and autonomic neuropathy (2.40 [1.32–4.36]) were the most important risk markers for mortality. Similar risk factors were found for all-cause, non-cardiovascular disease (CVD), unknown-cause, and CVD mortality.

CONCLUSIONS—Important risk factors for the increased total and non-CVD mortality in type 1 diabetic patients are age, WHR, pulse pressure, and non-HDL cholesterol. Microvascular complications from macroalbuminuria and peripheral and autonomic neuropathy are strong risk markers for future mortality exceeding the effect of the traditional risk factors.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 28 March 2008.

    Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted March 21, 2008.
    • Received January 23, 2008.
« Previous | Next Article »Table of Contents

This Article

  1. Published online before print March 28, 2008, doi: 10.2337/dc08-0107 Diabetes Care July 2008 vol. 31 no. 7 1360-1366
  1. » Abstract
  2. Full Text
  3. Full Text (PDF)
  4. All Versions of this Article:
    1. dc08-0107v1
    2. 31/7/1360 most recent

Current Issue

  1. December 2009, 32 (12)
  1. Current Issue
  1. Alert me to new issues of Diabetes Care