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Type 1 Diabetes Mortality

Mary Tyler Moore's Life Offers Hope For People With Type 1 Diabetes

Mary Tyler Moore's Life Offers Hope For People With Type 1 Diabetes

Mary Tyler Moore's death on Wednesday at age 80 may highlight the long-term effects that type 1 diabetes can have on the body. Moore died Jan. 25 after going into cardiopulmonary arrest, which means her heart stopped beating, several news outlets reported, citing Moore's publicist Mara Buxbaum. She had also recently contracted pneumonia. Moore had been diagnosed with type 1 diabetes when she was in her 30s. With new advances in medicine, type 1 diabetes no longer means a certain premature death, but it still has a significant impact on the body over time. [Extending Life: 7 Ways to Live Past 100] "The main way the body is affected is the chronic exposure to high blood sugar. These high blood sugars damage various organs — in particular, the eyes, kidneys and nerves — to increase cardiovascular disease," said Dr. Robert Gabbay, the chief medical officer at the Joslin Diabetes Center in Boston, a nonprofit research institution affiliated with Harvard Medical School. In people with type 1 diabetes, the pancreas has nearly completely stopped producing insulin, the hormone that allows the body cells to take in glucose and use it for energy. (This is a different condition from type 2 diabetes, which occurs when the body cannot produce enough insulin or use insulin effectively.) In those with type 1 diabetes, glucose instead builds up in the blood stream, and can cause fatigue, weakness, weight loss and excessive urination when untreated. Eventually, the disease can cause complications, including heart attack, strokes, blindness and kidney failure, according to the Joslin Diabetes Center. But is it possible to die from complications of type 1 diabetes? "Unfortunately, very much so," Gabbay told Live Science. "In the absence of insulin treatment, people with diabetes will d Continue reading >>

Time Trends In Mortality In Patients With Type 1 Diabetes: Nationwide Population Based Cohort Study

Time Trends In Mortality In Patients With Type 1 Diabetes: Nationwide Population Based Cohort Study

Abstract Objective To examine short and long term time trends in mortality among patients with early onset (age 0-14 years) and late onset (15-29 years) type 1 diabetes and causes of deaths over time. Design Population based nationwide cohort study. Setting Finland. Participants All Finnish patients diagnosed as having type 1 diabetes below age 30 years between 1970 and 1999 (n=17 306). Main outcome measures Crude mortality, standardised mortality ratios, time trends, and cumulative mortality. Results A total of 1338 deaths occurred during 370 733 person years of follow-up, giving an all cause mortality rate of 361/100 000 person years. The standardised mortality ratio was 3.6 in the early onset cohort and 2.8 in the late onset cohort. Women had higher standardised mortality ratios than did men in both cohorts (5.5 v 3.0 in the early onset cohort; 3.6 v 2.6 in the late onset cohort). The standardised mortality ratio at 20 years’ duration of diabetes in the early onset cohort decreased from 3.5 in the patients diagnosed in 1970-4 to 1.9 in those diagnosed in 1985-9. In contrast, the standardised mortality ratio in the late onset cohort increased from 1.4 in those diagnosed in 1970-4 to 2.9 in those diagnosed in 1985-9. Mortality due to chronic complications of diabetes decreased with time in the early onset cohort but not in the late onset cohort. Mortality due to alcohol related and drug related causes increased in the late onset cohort and accounted for 39% of the deaths during the first 20 years of diabetes. Accordingly, mortality due to acute diabetic complications increased significantly in the late onset cohort. Conclusion Survival of people with early onset type 1 diabetes has improved over time, whereas survival of people with late onset type 1 diabetes has det Continue reading >>

Type 1 Diabetes Mortality Rates Decreasing

Type 1 Diabetes Mortality Rates Decreasing

Type 1 diabetes mortality rates decreasing Please provide your email address to receive an email when new articles are posted on this topic. Receive an email when new articles are posted on this topic. Mortality rates for people with type 1 diabetes are decreasing, however, overall rates remain more than five times higher than those for the general population, a new study reported. While researchers at the University of Pittsburgh found no significant differences in mortality rates between sexes, women with type 1 diabetes were 13 times more likely to die compared with women who did not have diabetes. The researchers also discovered differences between races: a much higher proportion of blacks with type 1 diabetes (50.6%) died compared with whites (24%). This study was designed to document mortality rates of childhood-onset type 1 diabetes over the years, including how rates have improved and how they vary by sex and race, Trevor Orchard, MD, of the department of epidemiology, Graduate School of Public Health, University of Pittsburgh, told . The remarkable finding is the dramatic decline in mortality seen throughout follow-up for those in later diagnosed cohorts. Orchard and colleagues used the childhood-onset type 1 diabetes registry in Allegheny County, Pennsylvania, to study 1,075 people diagnosed with type 1 diabetes from 1965 to 1979. The cohort was divided into three groups: those diagnosed from 1965 to 1969; 1970 to 1974; and 1975 to 1979. As of Jan. 1, 2008, the researchers ascertained the vital status for 1,043 of the 1,075 people identified. There were 34,363 total person-years of follow-up. During a median follow-up of 33 years, 279 patients with type 1 diabetes died. According to other results, men with type 1 diabetes were five times more likely to die co Continue reading >>

Hypoglycemia In Children With Type 1 Diabetes: Unawareness Is A Concrete Risk

Hypoglycemia In Children With Type 1 Diabetes: Unawareness Is A Concrete Risk

The incidence of type 1 diabetes (T1D) is increasing rapidly, especially in younger age groups. The data from Western European Diabetes Mellitus Centers suggest an annual rate increase of 3–4% in children and adolescents1. The latest worldwide estimates show 415 million of patients with diabetes overall, that would become 642 million around 2040; there are 86,000 new cases a year of T1D among children and 542,000 patients worldwide2. The incidence varies approximately 400-fold between nations, with wide variations among regions of the same state. For example, the incidence of T1D in Italy is significantly different from the observed rate in Sardinia3 (epidemiologic data in 2011: 45/100,000 new cases per year between 0 and 14 years of age), that has a trend of increase second only to Finland2,4. International consensus and guidelines have underlined the relevance of multiple dose insulin therapy to obtain a near physiological glycosylated hemoglobin (HbA1c) that may prevent or slow the progression of chronic complications of T1D5. The Diabetes Control and Complications Trial (DCCT) has demonstrated that intensive therapy delays microvascular complications in adolescents and adults and euglycemia has a great impact on the management of diabetes in the young6. However, a stricter control of glycemic values also increases the risk of severe hypoglycemia7. Severe hypoglycemia is one of the most dangerous acute complications during insulin treatment in patients with T1D. Hypoglycemia is defined as an abnormally low plasma glucose concentration that may expose the individual to potential harm8. Metabolic impairment is a basic aspect in diabetes and may have severe outcomes on multiple physiologic pathways; glycemic control has a relevant role in this metabolic change and it Continue reading >>

Cytokine-induced β-cell Stress And Death In Type 1 Diabetes Mellitus | Intechopen

Cytokine-induced β-cell Stress And Death In Type 1 Diabetes Mellitus | Intechopen

1.1. Pathophysiology of type I diabetes mellitus: Role of pro-inflammatory cytokines Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterised by the destruction of insulin-producing -cells in the pancreatic islets of Langerhans ( Fig.1 ), which is mediated by autoreactive T cells, macrophages and pro-inflammatory cytokines ( Fig.2 ). This leads to an inability to produce sufficient insulin resulting in elevated blood glucose levels and pathological effects ( Eizirik & Mandrup-Poulsen, 2001 ). T1DM is believed to be initiated by physiological -cell death or islet injury triggering the homing of macrophages and dendritic cells that in turn launch an inflammatory reaction. The infiltrating macrophages secrete pro-inflammatory cytokines, namely interleukin-1 (IL-1) and tumour necrosis factor (TNF) as well as various chemokines that attract immune cells such as dendritic cells, macrophages and T lymphocytes. T cells recognising -cell-specific antigens become activated, infiltrate the inflamed islets and attack the -cells ( Baekkeskov et al., 1990 , Elias et al., 1995 , Lieberman et al., 2003 , Nakayama et al., 2005 ). In a normally functioning immune system, T cells with a high affinity for self-antigens are eliminated during their differentiation resulting in immune tolerance. Autoreactive cells that have escaped these mechanisms are subject to peripheral immune regulation that blocks their activation and clonal expansion, preventing development of an autoimmune disease ( Mathis & Benoist, 2004 ). For reasons we do not fully understand, these immune regulatory mechanisms either fail to launch, or are ineffective in stopping the immune attack against the -cells in T1DM, and a positive feedback cycle is established ( Mathis & Benoist, 2004 ). This forward-feedi Continue reading >>

Treatment Non-compliance And Mortality In Patients With Type 1 Diabetes

Treatment Non-compliance And Mortality In Patients With Type 1 Diabetes

Treatment Non-compliance and Mortality in Patients with Type 1 Diabetes The extent to which patients are compliant with their type 1 diabetes treatment may have an effect on their all-cause mortality risk, according to the results of a study. Researchers at Cardiff University in the United Kingdom recently explored the effects of non-compliance (both medication non-compliance, and not showing up for scheduled medical appointments) on all-cause mortality rates in people living with type 1 diabetes. Their study, The impact of treatment non-compliance on mortality in people with type 1 diabetes, was published online ahead of print in November 2012. It appears in the Journal of Diabetes and its Complications. The researchers relied on data from The Health Improvement Network (THIN) database which contains information on patients seen at more than 350 facilities in the United Kingdom. Only participants who had diagnostic codes that indicated type 1 diabetes were included in the study. Treatment non-compliance was defined as missing medications or missing one or more scheduled medical appointments. The results of the study showed that 29.4% of the patients included in the study (867 out of 2,946) were non-compliant in their medication regimen, or missed medical appointments during the 30-month assessment period. After controlling for confounding factors, the researchers found that patients who were not compliant with their treatment had a mortality rate of 1.462 (95% CI 0.954-2.205), and that treatment non-compliance was linked to a heightened risk of all-cause mortality in these patients. The researchers conclude that their findings demonstrate an association between all-cause mortality and treatment non-compliance (both medication non-compliance and missing scheduled medic Continue reading >>

Mortality Trends In Type 1 Diabetes

Mortality Trends In Type 1 Diabetes

The Allegheny County (Pennsylvania) Registry 1965–1999 Abstract OBJECTIVES—To investigate long-term mortality and its temporal trends as of 1 January 1999 among the 1,075 patients with type 1 diabetes (onset age <18 years, diagnosed between 1965 and 1979) who comprise the Allegheny County population-based registry. RESEARCH DESIGN AND METHODS—Overall, sex- and race-specific mortality rates per person-year of follow-up were determined. Standardized mortality ratios were also calculated. Survival analyses and Cox proportional hazard model were also used. Temporal trends were examined by dividing the cohort into three groups by year of diagnosis (1965–1969, 1970–1974, and 1975–1979). RESULTS—Living status of 972 cases was ascertained as of January 1, 1999 (ascertainment rate 90.4%). The mean duration of diabetes was 25.2 ± 5.8 (SD) years. Overall, 170 deaths were observed. The crude mortality rate was 627 per 100,000 person-years (95% CI 532–728) and standardized mortality ratio was 519 (440–602). Life-analyses by the Kaplan-Meier method indicated cumulative survival rates of 98.0% at 10 years, 92.1% at 20 years, and 79.6% at 30 years duration of diabetes. There was a significant improvement in the survival rate between the cohort diagnosed during 1965–1969 and that diagnosed during 1975–1979 by the log-rank test (P = 0.03). Mortality was higher in African-Americans than in Caucasians, but there were no differences seen by sex. The improvement in recent years was seen in both ethnic groups and sexes. CONCLUSIONS—An improvement in long-term survival was observed in the more recently diagnosed cohort. This improvement is consistent with the introduction of HbA1 testing, home blood glucose monitoring, and improved blood pressure therapy in the 1980s. Continue reading >>

Mortality Due To Diabetes

Mortality Due To Diabetes

Key Messages Canada receives a “C” and ranks 15th out of 17 peer countries on mortality due to diabetes. Two million Canadians suffer from diabetes, a figure that is expected to increase to three million over the next decade. The prevalence of diabetes in Canada continues to increase. Putting mortality due to diabetes in context Diabetes is a global epidemic and, according to the International Diabetes Federation, “one of the most challenging health problems in the 21st century.” In 2011, diabetes accounted for about 4.6 million deaths worldwide.1 Globally, it is estimated that more than 350 million people suffer from diabetes; this number is expected to jump to over 550 million by 2030, if nothing is done.2 An estimated 280 million people worldwide have an impaired glucose tolerance—a precursor to diabetes. This number is projected to reach 398 million by 2030, or 7 per cent of the adult population.3 Diabetes has also shifted down a generation—from a disease of the elderly to one that affects those of working age or younger. According to the International Diabetes Federation, as a result of decreasing levels of physical activity and increasing obesity rates, type 2 diabetes in children has the potential to become a global public health issue.4 If you enjoyed this research, get regular updates by signing up to our monthly newsletter. Please enter your e-mail. Your e-mail was not in the correct format. It should be in the form [email protected] What is diabetes? Diabetes is a chronic, often debilitating, and sometimes fatal disease that occurs when there are problems with the production and use of insulin in the body, ultimately leading to high blood sugar levels. Long-term complications from diabetes include kidney disease, diminishing sight, loss of feeling in t Continue reading >>

Glycemic Control And Excess Mortality In Patients With Type 1 Diabetes Mellitus

Glycemic Control And Excess Mortality In Patients With Type 1 Diabetes Mellitus

Sucheta Gosavi, MD Mortality in patients with type 1 diabetes mellitus (T1DM) is higher than in the general population, and whether mortality improves or alters with glycemic control is unknown. In their article “Glycemic Control and Excess Mortality in Type 1 Diabetes Mellitus,” Marcus Lind, MD, and colleagues conducted an observational study in the Swedish population in patients with type 1 diabetes mellitus (T1DM) to determine the mortality rate and causes of death in this population.1 Study Details A total of 33,915 patients with T1DM were followed from January 1, 1998 to December 31, 2011. For each diabetic patient, 5 controls were randomly selected from the general population and matched according to age, sex, and county. A total of 169,249 controls were followed for a similar period. Mean age of the patient population and control population was 35 years; 45% of each group was female.The educational level of the patients and controls was also similar in the 2 groups. T1DM was defined on the basis of epidemiologic data: definite diagnosis of diabetes mellitus at 30 years or younger, and treatment with insulin. An updated mean glycated hemoglobin (A1C) that was an average of 3 values of A1C done during the study period was used. Two renal variables were used to compare mortality between patients and controls, with the first categorized as normoalbuminuria, microalbuminuria, macroalbuminuria, or stage 5 chronic kidney disease (CKD), and the second categorized as an eGFR of 15 to <60 mL/min, between 60 and 120 mL/min, or >120 mL/min. Cox regression models were used in the statistical analysis. The study results revealed that mortality rate for patients with T1DM was 8%, and for control, 2.9%. Hazard ratios for death from any cause and death from cardiovascular cau Continue reading >>

Diabetes Before And After

Diabetes Before And After

The word ‘Diabetes’ comes from the Greek word that means “pipe-like” or “to pass through”. Not many people realize that it is responsible for claiming the lives of people for over thousands of years. In the body of someone with diabetes, they are unable to use the nutrients in the food for energy, this causes extra glucose to collect in the blood as well as the urine. Food them simply just “passes through” their body and does not absorb any nutrients. Before the discovery of insulin, diabetes was a fatal disease. Treatments Throughout History The Egyptians treated people with diabetes by using a combination of water, bones, lead, wheat and ground earth. In the 19th and 20th centuries, opium helped to reduce the pain and despair that was felt by dying patients with diabetes. In the 19th century, doctors also tried other common practices of healing such as cupping, bleeding and blistering. The starvation diet was regularly prescribed to patients with diabetes prior to 1922. The Prognosis of Diabetes Before Insulin Imagine being a doctor, who got into the field of medicine to treat and heal patients, but after countless tries they always failed to treat patients with diabetes. Children began to waste away, suffering to take their next breath right before their very eyes and there was absolutely nothing they could do about it. Before the discovery of insulin, this was the very fate for patients young and old diagnosed with this deadly disease. Adults typically lived under two years, while children rarely lived longer than one years’ time. They suffered greatly with blindness, loss of limbs, stroke, heart attacks, kidney failure and eventually death. Diabetic patients who used the starvation diet as their treatment method were painfully malnourished, and ty Continue reading >>

Glycemic Control And Excess Mortality In Type 1 Diabetes

Glycemic Control And Excess Mortality In Type 1 Diabetes

The excess risk of death from any cause and of death from cardiovascular causes is unknown among patients with type 1 diabetes and various levels of glycemic control. We conducted a registry-based observational study to determine the excess risk of death according to the level of glycemic control in a Swedish population of patients with diabetes. We included in our study patients with type 1 diabetes registered in the Swedish National Diabetes Register after January 1, 1998. For each patient, five controls were randomly selected from the general population and matched according to age, sex, and county. Patients and controls were followed until December 31, 2011, through the Swedish Register for Cause-Specific Mortality. The mean age of the patients with diabetes and the controls at baseline was 35.8 and 35.7 years, respectively, and 45.1% of the participants in each group were women. The mean follow-up in the diabetes and control groups was 8.0 and 8.3 years, respectively. Overall, 2701 of 33,915 patients with diabetes (8.0%) died, as compared with 4835 of 169,249 controls (2.9%) (adjusted hazard ratio, 3.52; 95% confidence interval [CI], 3.06 to 4.04); the corresponding rates of death from cardiovascular causes were 2.7% and 0.9% (adjusted hazard ratio, 4.60; 95% CI, 3.47 to 6.10). The multivariable-adjusted hazard ratios for death from any cause according to the glycated hemoglobin level for patients with diabetes as compared with controls were 2.36 (95% CI, 1.97 to 2.83) for a glycated hemoglobin level of 6.9% or lower (≤52 mmol per mole), 2.38 (95% CI, 2.02 to 2.80) for a level of 7.0 to 7.8% (53 to 62 mmol per mole), 3.11 (95% CI, 2.66 to 3.62) for a level of 7.9 to 8.7% (63 to 72 mmol per mole), 3.65 (95% CI, 3.11 to 4.30) for a level of 8.8 to 9.6% (73 to 82 mm Continue reading >>

Exercise Tied To Lower Odds Of Premature Death With Type 1 Diabetes

Exercise Tied To Lower Odds Of Premature Death With Type 1 Diabetes

November 8, 2017 / 9:03 PM / 2 years ago Exercise tied to lower odds of premature death with type 1 diabetes (Reuters Health) - People with type 1 diabetes who exercise - and the more the better - are less likely to die prematurely than their sedentary counterparts, a recent study suggests. Researchers examined data on the frequency, intensity and duration of leisure time physical activity for 2,639 patients with type 1 diabetes in Finland. After an average follow-up of about 11 years, 270 participants died. Compared to the people who spent little or no time exercising, participants who reported devoting the most time to physical activity were less likely to die during the study, even when they had kidney disease. It matters because doctors have always prescribed physical activity for their patients with (type 1) diabetes without strong evidence, said lead study author Dr. Heidi Tikkanen-Dolenc of the University of Helsinki and Helsinki University Hospital. Exercise has long been linked to better survival odds and fewer complications for people with whats known as type 2 diabetes, the more common form of the disease thats tied to obesity and aging. Type 2 diabetes develops when the body cant properly use or make enough of the hormone insulin to help convert blood sugar into energy. But its been less clear how exercise influences longevity for patients with type 1 diabetes, which happens when the body doesnt make insulin and is usually diagnosed in childhood or early adulthood. Left untreated, both types of diabetes can lead to nerve damage, kidney damage known as nephropathy, and complications in the heart, blood vessels and eyes. Often, people with diabetes eventually die of heart or kidney disease. Now we can say that in patients with type 1 diabetes, physical activi Continue reading >>

Death Rates Due To Diabetes

Death Rates Due To Diabetes

You asked Please could I obtain the death rates due to diabetes related causes within the UK during 2012, 2013, 2014, 2015. We said Thank you for your query on deaths related to diabetes. The number of deaths registered in England and Wales each year by sex, age and underlying cause are available from the Office for National Statistics (ONS) Mortality Statistics: Deaths Registered in England and Wales (Series DR) release. This is available on the ONS website: Special extracts and tabulations of mortality data, including the calculation of mortality rates for specific causes, are available to order (subject to legal frameworks, disclosure control, resources and agreements of costs, where appropriate). Such enquiries should be made to: [email protected] We recommend that you contact the Mortality Analysis team directly in order to discuss your data requirements in more detail. As this information is already available to you via this route ONS considers that S21(1) applies to this request and the information does not have to be supplied under the terms of the Freedom of Information Act. S21(1) is an absolute exemption and no consideration of the public interest test needs to be applied. Continue reading >>

Diabetes Mellitus Type 1

Diabetes Mellitus Type 1

Diabetes mellitus type 1 (also known as type 1 diabetes) is a form of diabetes mellitus in which not enough insulin is produced.[4] This results in high blood sugar levels in the body.[1] The classical symptoms are frequent urination, increased thirst, increased hunger, and weight loss.[4] Additional symptoms may include blurry vision, feeling tired, and poor healing.[2] Symptoms typically develop over a short period of time.[1] The cause of type 1 diabetes is unknown.[4] However, it is believed to involve a combination of genetic and environmental factors.[1] Risk factors include having a family member with the condition.[5] The underlying mechanism involves an autoimmune destruction of the insulin-producing beta cells in the pancreas.[2] Diabetes is diagnosed by testing the level of sugar or A1C in the blood.[5][7] Type 1 diabetes can be distinguished from type 2 by testing for the presence of autoantibodies.[5] There is no known way to prevent type 1 diabetes.[4] Treatment with insulin is required for survival.[1] Insulin therapy is usually given by injection just under the skin but can also be delivered by an insulin pump.[9] A diabetic diet and exercise are an important part of management.[2] Untreated, diabetes can cause many complications.[4] Complications of relatively rapid onset include diabetic ketoacidosis and nonketotic hyperosmolar coma.[5] Long-term complications include heart disease, stroke, kidney failure, foot ulcers and damage to the eyes.[4] Furthermore, complications may arise from low blood sugar caused by excessive dosing of insulin.[5] Type 1 diabetes makes up an estimated 5–10% of all diabetes cases.[8] The number of people affected globally is unknown, although it is estimated that about 80,000 children develop the disease each year.[5] With Continue reading >>

Morbidity And Mortality In Diabetic Patients On Peritoneal Dialysis. Twenty-five Years Of Experience At A Single Centre

Morbidity And Mortality In Diabetic Patients On Peritoneal Dialysis. Twenty-five Years Of Experience At A Single Centre

Tab. 2. Causes of Hospitalisation and PD Discontinuation in Diabetic and Non-Diabetic Patients Aims: To describe PD outcomes over 25 years in a single centre, comparing hospitalisation rate, technique withdrawal, and survival between diabetic (DM) and non-diabetic (NonDM) patients. Differences between type 1 (DM1) and type 2 (DM2) diabetics were also analysed. Patients and methods: One hundred and eighteen DM patients (52 year old average, 74 men, 44 female) and 117 Non-DM (53 year old average, 64 men, 53 female), with at least 2 months on PD, 2520 (2-109) and 29.427 (2-159) months respectively, were included. Diabetics were divided in 66 DM1 and 52 DM2. The survival and hospitalisation study was also analysed in two different time periods: before 1992 (1981-1992) and after 1992 (1993-2005). Results: 93% Non-DM and 75% DM were self-sufficient to manage the PD technique (P<.001) as well as 65% of 44 blind patients. 28% of Non-DM and 15% of DM received a renal allograft (P<.001). There was no difference in transfer to haemodialysis. 18.6% of DM and 4.3% of Non-DM patients presented >4 comorbid factors on starting PD (P<.001). Hospitalisation (admissions/year) was higher in DM than in Non-DM patients (3.4 vs 1.8, P<.01) and also hospitalisation length (46 vs 22 days/year, P=.01), without differences between DM1 and DM2. Admissions due to cardiovascular events, infections, technical problems and peritonitis were more frequent in DM2 than in Non-DM and DM1 patients (P<.05). However, DM2patients admitted to hospital for peritonitis did not spend more days in hospital than Non-DM or DM1 patients. Mortality was 48% in DM and 22% in Non-DM (P<.001). Survival adjusted for comorbidity was higher in Non-DM (P<.001). Cerebrovascular disease was the highest risk factor for mortality Continue reading >>

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