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dc.contributor.authorPatterson, C C
dc.contributor.authorDahlquist, G
dc.contributor.authorHarjutsalo, V
dc.contributor.authorJoner, G
dc.contributor.authorFeltbower, R G
dc.contributor.authorSvensson, J
dc.contributor.authorSchober, E
dc.contributor.authorGyürüs, E
dc.contributor.authorCastell, C
dc.contributor.authorUrbonaité, B
dc.contributor.authorRosenbauer, J
dc.contributor.authorIotova, V
dc.contributor.authorThorsson, A V
dc.contributor.authorSoltész, G
dc.date.accessioned2010-06-11T09:37:08Z
dc.date.available2010-06-11T09:37:08Z
dc.date.issued2007-12-01
dc.date.submitted2010-07-11
dc.identifier.citationDiabetologia. 2007, 50(12):2439-42en
dc.identifier.issn0012-186X
dc.identifier.pmid17901942
dc.identifier.doi10.1007/s00125-007-0824-8
dc.identifier.urihttp://hdl.handle.net/2336/104665
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractAIMS/HYPOTHESIS: The aims of this study were to provide a contemporary picture of mortality and causes of death in Europe following a diagnosis of type 1 diabetes made before the 15th birthday, and to examine excess mortality by country for possible links to incidence level or national prosperity. METHODS: Thirteen population-based EURODIAB registers in 12 countries followed-up 28,887 children diagnosed since 1989, either by record linkage to population registers or through contact with doctors providing care. RESULTS: There were 141 deaths in the cohort during 219,061 person-years of follow-up compared with 69.1 deaths expected from national mortality rates, a standardised mortality ratio (SMR) of 2.0 (95% CI 1.7-2.4). The SMR varied from 0 to 4.7 between countries, but showed little relationship with the country's incidence rate or gross domestic product (US$ per capita). The SMR did not change significantly with attained age, calendar period or time since diagnosis. The female SMR (2.7; 95% CI 2.0-3.5) was greater than the male SMR (1.8; 95% CI 1.4-2.2), although absolute numbers of excess deaths were similar in the two sexes. One-third of deaths were classified as directly attributable to diabetes (many with mention of ketoacidosis) and half were unrelated to diabetes. There was a non-significant excess of accidental/violent deaths (48 observed vs 40.7 expected; SMR 1.2; 95% CI 0.9-1.6) but little excess in suicides (11 observed, 10.2 expected; SMR 1.1; 95% CI 0.5-1.9). CONCLUSIONS/INTERPRETATION: Before the onset of late complications, significant excess mortality existed following the diagnosis of type 1 diabetes in childhood, even in recent years. Variation between countries in this excess could not be explained.
dc.language.isoenen
dc.publisherSpringer Verlagen
dc.relation.urlhttp://dx.doi.org/10.1007/s00125-007-0824-8en
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAge of Onseten
dc.subject.meshCause of Deathen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshCohort Studiesen
dc.subject.meshDiabetes Mellitus, Type 1en
dc.subject.meshEuropeen
dc.subject.meshFemaleen
dc.subject.meshFollow-Up Studiesen
dc.subject.meshInfanten
dc.subject.meshInfant, Newbornen
dc.subject.meshMaleen
dc.subject.meshRegistriesen
dc.titleEarly mortality in EURODIAB population-based cohorts of type 1 diabetes diagnosed in childhood since 1989en
dc.typeArticleen
dc.contributor.departmentDepartment of Epidemiology and Public Health, Queen's University Belfast, Belfast, UK. c.patterson@qub.ac.uken
dc.identifier.journalDiabetologiaen
html.description.abstractAIMS/HYPOTHESIS: The aims of this study were to provide a contemporary picture of mortality and causes of death in Europe following a diagnosis of type 1 diabetes made before the 15th birthday, and to examine excess mortality by country for possible links to incidence level or national prosperity. METHODS: Thirteen population-based EURODIAB registers in 12 countries followed-up 28,887 children diagnosed since 1989, either by record linkage to population registers or through contact with doctors providing care. RESULTS: There were 141 deaths in the cohort during 219,061 person-years of follow-up compared with 69.1 deaths expected from national mortality rates, a standardised mortality ratio (SMR) of 2.0 (95% CI 1.7-2.4). The SMR varied from 0 to 4.7 between countries, but showed little relationship with the country's incidence rate or gross domestic product (US$ per capita). The SMR did not change significantly with attained age, calendar period or time since diagnosis. The female SMR (2.7; 95% CI 2.0-3.5) was greater than the male SMR (1.8; 95% CI 1.4-2.2), although absolute numbers of excess deaths were similar in the two sexes. One-third of deaths were classified as directly attributable to diabetes (many with mention of ketoacidosis) and half were unrelated to diabetes. There was a non-significant excess of accidental/violent deaths (48 observed vs 40.7 expected; SMR 1.2; 95% CI 0.9-1.6) but little excess in suicides (11 observed, 10.2 expected; SMR 1.1; 95% CI 0.5-1.9). CONCLUSIONS/INTERPRETATION: Before the onset of late complications, significant excess mortality existed following the diagnosis of type 1 diabetes in childhood, even in recent years. Variation between countries in this excess could not be explained.


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