Time Trends for Mortality Among Patients with Early- vs. Late-Onset Type 1 Diabetes

Early-onset patients are faring better, but late-onset patients are doing worse.


In this population-based, nationwide cohort study of Finnish patients with type 1 diabetes, investigators examined time trends for mortality among 10,500 patients who developed early-onset disease (age range, 0–14 years) and 6800 who developed late-onset disease (age range, 15–29) between 1970 and 1999. Mean follow-up was 21.4 years.

Excess mortality was higher in the early-onset group than in the late-onset group (standardized mortality ratio [SMR], 3.6 for early-onset and 2.8 for late-onset vs. the general population). At 20 years' duration of diabetes, SMRs for the early-onset group were lower in patients whose diagnoses were made in 1985–1989 than in patients with diagnoses in 1970–1974, whereas SMRs in the late-onset group were higher in patients whose diagnoses occurred at later dates. Mortality caused by chronic complications of diabetes decreased over time in the early-onset group but not in the late-onset group. Mortality caused by acute complications of diabetes and alcohol- and drug-related causes increased over time in the late-onset group.


Citation(s):

Harjutsalo V et al. Time trends in mortality in patients with type 1 diabetes: Nationwide population based cohort study. BMJ 2011 Sep 8; 343:d5364.