Excess Mortality for Adults with Young-Onset Diabetes Persists

Baqiyyah N. Conway, Ph.D., of Vanderbilt University in Nashville, Tenn., and associates described the mortality experience of a low-income, predominantly minority population with diabetes diagnosed before age 30. Participants included 1,098 adults (age 40 to 79 years) diagnosed with diabetes and 49,914 adults without diabetes. Participants with diabetes were stratified by insulin therapy at baseline: group A treated with insulin only; group B treated with insulin and oral hypoglycemic agent; and group C receiving no insulin treatment.

During a mean follow-up of 3.9 years, the researchers found that 4.6 percent of the cohort without diabetes died, compared with 15, 12.5, and 7.3 percent of groups A, B, and C, respectively. The hazard ratios (HRs) for all-cause mortality were 4.3, 4.2, and 2.0 for groups A, B, and C, compared with individuals without diabetes. The leading cause of death in groups A, B, and C were ESRD, ESRD and CAD, and CAD, respectively. The HRs for these conditions were at least twice as high as the HRs for all-cause mortality, extending to 17.3, 17.9, and 5.1 in groups A, B, and C, respectively, for ESRD.

"Excess mortality persists among people with young-onset diabetes of long duration, with ESRD and CAD as the leading contributors to mortality," the authors write.