Mortality rates for people with type 1 diabetes are decreasing, but overall remain seven times higher than those of the general population -- likely as a result of long-term complications, a study in the December issue of Diabetes Care reports.

And while there were no significant differences in mortality rates between genders, women with type 1 diabetes were 13 times more likely to die than women who did not have diabetes, reported researchers from the University of Pittsburgh. Also in this study, part of the Epidemiology Research International Study Group, a much higher proportion of African Americans (50.6 percent) died than Caucasians (24 percent).

"It`s unclear why, for both women and African Americans, type 1 diabetes has such a major effect compared to the general population," said Dr. Trevor Orchard, senior author of the study. "This greater effect of diabetes for women is not seen as strongly in studies in other parts of the world. One thing that is clear is that we need to pay special attention to their care and treatment and continue to investigate why they might be disproportionately impacted by the long-term consequences of this disease."

Overall, mortality rates for people with type 1 diabetes fell significantly in this community-based population from Allegheny County, PA, over the past several decades, the study found. For those diagnosed between 1965 and 1969, mortality rates were 9.3 times higher than the general population. However, for those most recently diagnosed (1975-1979), the rate was just 5.6 times higher, showing a clear decline.

"It looks like the main improvement in those most recently diagnosed is related to dramatically reducing mortality in the first five years after diagnosis," said Dr. Aaron Secrest, lead author of the paper. "We think it`s probably a result of better management and awareness of diabetes control, leading to providers and patients doing a better job of monitoring for acute complications."

Overall, reductions in mortality are most likely due to the tremendous improvements in treatment and care during the 1980s and 1990s, the researchers noted. In particular, blood glucose self-monitoring, A1C testing and use of new blood pressure medications such as angiotensin-converting enzyme inhibitors, which also help protect against diabetic kidney disease. These changes have greatly improved both blood sugar and blood pressure control, often the cause of life-threatening complications.

The study looked at people in Allegheny County the Pittsburgh area who had type 1 diabetes diagnosed as a child between 1965 and 1979 and at the time of analysis had a duration of diabetes between 28 and 43 years, and explored differences in mortality based on sex, race (Caucasian vs. African American) and year of diagnosis.

 

Source: American Diabetes Association Press Release

Originally posted by DiabetesCare.net on December 7, 2010.