Mortality Grows in Diabetic and Pre-Diabetic Patients

Diabetes survival rates are decreasing and the death rate for individuals with pre-diabetes increased from 11.19 to 14.02 deaths per 1,000 person-years….

A new study, comparing two nationally represented cohorts, found a "non-significant increase in mortality over time" in diabetic and pre-diabetic patients. This finding was consistent even when the death rates dropped from those without conditions. This study involved two studies that compared patients from 1988-1994 and 1999-2002. Measuring in deaths per 1,000 person-years, the mortality rate for diabetics rose from 20.34 to 20.82 and for pre-diabetics from 11.19 to 14.02.

In contrast, the death rate decreased from 7.81 to 6.04 deaths per 1,000 person-years when comparing populations with normal blood sugar (no diabetes).

Investigators categorized patients according to blood sugar levels based on measures of hemoglobin A1c (HbA1c). The authors said that their study was different from other similar studies that had been based only on self-reported diabetes.

Andrew Stokes, from the Population Studies Center at the University of Pennsylvania in Philadelphia added that, "Our use of the HbA1c criteria allowed us to incorporate data from individuals at high-risk for diabetes [pre-diabetes] and those with undiagnosed diabetes." Some of these patients, he remarked, may be particularly vulnerable to premature death because they have not been officially diagnosed with diabetes and are not receiving treatment.

 "We found that individuals with pre-diabetes and diabetes, taken together, experienced persistently higher mortality rates compared to the normo-glycemic population during 1988-2006, with no evidence of a narrowing gap."

In conclusion Stokes stated that, "Future work should verify these findings in larger datasets and using more recent cohort experience. Trends should also be examined in more detail — by gender, race/ethnicity and separately for individuals with pre-diabetes versus diabetes."

Population Health Metrics, Feb. 28, 2013; "Mortality and excess risk in US adults with pre-diabetes and diabetes: a comparison of two nationally representative cohorts, 1988-2006"