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Issue 201 Item 13 High Mortality Among Young Hospitalized Diabetics

People under 30 who are admitted to hospital for diabetes type 1 are at substantially increased risk of dying from natural causes and suicide. Although death in young people with diabetes is not common, those hospitalized for the condition are nine times more likely than the general population to die within three years of admission, write Dr. Stephen E Roberts and colleagues from the University of Oxford. Furthermore, they point out that these ratios “were higher than those of 2 to 4 recently reported from population based diabetes cohorts and registers.”

The researchers analyzed all National Health Service hospital admissions for diabetes mellitus within the area covered by the Oxford record linkage study between 1968 and1996. They found 4992 admissions for diabetes in people under 30 years in that period.

There were 58 deaths during 3 years of follow-up, including 32 in the first year and 15 during the first admission to hospital. Coroners’ reports recorded 29 cases of death due to diabetes mellitus, 14 from other diseases, 9 by suicide and 6 from accidents.

For the 1010 people admitted with diabetic coma or ketoacidosis, standardized mortality ratios were 27.9 in the first year and 12.9 at 3 years. The standardized mortality ratio at three years for suicide was 11.7.

In light of this, the authors conclude that people hospitalized for type 1 diabetes — who make up the majority of diabetes cases in this age group — should be considered as being at much greater risk of death, than the type 1 diabetes population overall. BMJ 2004;328:741-742.