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Type 1 Diabetes Mortality

The Burden Of Type 1 Diabetes

The Burden Of Type 1 Diabetes

Epidemiology Overall, type 1 diabetes (T1D) accounts for approximately 5% of diabetes and affects about 20 million individuals worldwide. Among those younger than 20 years of age, T1D accounts for the majority of T1D cases (1,2). The current U.S. prevalence estimate of 1-3 million T1D patients may triple by 2050 due to a rising incidence of T1D (3). Worldwide, T1D incidence has been rising by approximately 3% per year (1,4), possibly in association with changes in the humoral autoimmune response to islet antigens (5). Other factors implicated in the rising incidence include early childhood infections, dietary protein makeup, insulin resistance, and inflammatory factors (6,7). Morbidity and Mortality Diabetic complications—retinopathy, nephropathy, neuropathy, and cardiovascular disease (CVD)—are the major causes of morbidity and mortality in persons with T1D, although severe hypoglycemia and diabetic ketoacidosis (DKA) are also associated with high mortality rates, particularly in younger patients (5-10). Although the role of glucose control in reducing the risk of diabetes complications is well-established (11,12), real-world data show that rates of complications remain high, particularly in patients with suboptimal control. An analysis of the Diabetic Control and Complications Trial (DCCT) and Pittsburgh Epidemiology of Diabetes Complications (EDC) study populations revealed that the 30-year cumulative incidence of retinopathy was 50% among DCCT patients randomly assigned conventional therapy at the start of that trial, while the observational EDC study population had a 47% cumulative incidence over 30 years. Nephropathy rates were 25% and 17% in the DCCT-conventional and EDC cohorts, respectively, and 14% of patients had CVD in these two groups. In contrast, 30-y Continue reading >>

Natural History

Natural History

The pre-insulin era Childhood onset diabetes was rare – or at least, rarely diagnosed – in the pre-insulin era. Elliot Joslin collected such cases, despaired of by other physicians, and reported in 1917[1] that of 59 who developed diabetes before the age of 10, 38 had died within an average of 1.4 years. Their prognosis had however improved with a low carbohydrate ('Eskimo') diet. Death was from starvation, tuberculosis or diabetic coma. Lack of access to insulin in the world's poorest countries is still, in 2012, the commonest cause of death in a child with diabetes.[2] Joslin himself termed the period from 1898 to 1914 the Naunyn era, after the famous German physician, and the period from 1914 to 1922 the Allen era in honour of the undernutrition treatment which kept children alive, but at a terrible price. The period from 1922 to 1935 was named for Banting and Best, and the period after 1935 for Hagedorn, the Danish physician who introduced the first long-acting insulin. Each saw a steady prolongation of life for young patients on insulin. The prognosis on insulin Insulin was like a cure for cancer. Physicians such as Joslin soon learned that diabetic coma, previously fatal, could not only be treated with insulin with great success, but also prevented by appropriate education of families and their physicians. Tuberculosis became much less of a threat once children were properly nourished. Beyond this point, the future of children with diabetes was unknown. Joslin's 1935 medal pictured them as 'Explorers of Unknown Seas'. Sadly, it emerged in the 1930s that they were at risk of the delayed complications of diabetes: kidney disease, eye problems and premature heart disease. As a result, only one person in two who started insulin before the age of 20 would live to s Continue reading >>

5 Common Type 1 Diabetes Complications

5 Common Type 1 Diabetes Complications

3 0 Type 1 diabetes carries with it a much higher risk of developing some associated serious health problems. While in the past, getting diabetes-related health complications was almost a certainty, with modern blood glucose monitoring, control, and treatment, the risks have decreased significantly. Even a few decades ago, life expectancy for people with diabetes was regularly considered to be 10 years shorter than for people without the disorder. In 2012, however, a large-scale study found that life-expectancy was now only about 6 years less than average. For comparison, a lifetime of smoking will reduce life expectancy by 10 years. So what are the diabetes complications that you need to be looking out for? Largely, they fall into either cardiovascular or neuropathic categories. To make diabetes complications even more complicated, they tend to affect people of different sexes and different ethnicities differently. One more wild card is that recent studies have found that some people with Type 1 diabetes actually never develop most of the complications associated with diabetes. The good news is that with proper blood glucose control and a healthy lifestyle, the risks for developing Type 1 diabetes complications are drastically reduced. Some studies have actually found that careful monitoring and management can reduce the chances of developing any of these by as much as 50%. Still, everyone with Type 1 diabetes should keep a careful eye out for the five most common diabetes complications. Diabetic Ketoacidosis Diabetic Ketoacidosis (or DKA), is a condition caused by severe hyperglycemia (high blood sugar) which causes rapid fat breakdown in the body. As the fat breaks down, they release fatty acids which are then converted into chemicals called ketones, which are highly 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 >>

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 >>

Mortality Rates Plummet Among Diabetes Sufferers

Mortality Rates Plummet Among Diabetes Sufferers

Open this photo in gallery: Diabetes has become remarkably less deadly over the past generation, new research reveals. In 2009, a Canadian living with diabetes had a life expectancy that was six years less than a comparable person without diabetes. In 1996, the diabetes sufferer would have had an 11-year reduction in life expectancy. "That's a big difference," Dr. Lorraine Lipscombe, a research scientist at the Women's College Research Institute in Toronto, said in an interview. "But people with diabetes still have a significant reduction in life expectancy." While the new study did not examine why mortality dropped, Lipscombe said it likely reflects a number of medical advances and societal changes. For example, screening for diabetes is more commonplace and treatment is more aggressive, particularly when it comes to blood pressure control. As well, the number of people who smoke has dropped, and treatments for heart disease have improved a lot. Diabetes, a disease in which the pancreas does not produce enough insulin or the body does not properly use the insulin it produces, is highly damaging to the heart. "We're seeing a lot fewer cardiovascular events in the patient population," Lipscombe said. "And when people do have a heart attack, we're a lot better at treating them." The new research, published Thursday in the medical journal Diabetologia, examined changes in the "excess risk of mortality" among patients with diabetes in Ontario and in the United Kingdom. In Ontario in 1996, a person living with diabetes was about 90 per cent more likely to die than a comparable person without diabetes. But 2009, that excess risk of mortality had fallen to 51 per cent. In the U.K., the excess rate of mortality fell to 65 per cent from 214 per cent during that same time period. Continue reading >>

Mortality Rates For Type 1 Diabetes Patients Still Too High

Mortality Rates For Type 1 Diabetes Patients Still Too High

Despite major advances in the treatment of type 1 diabetes over the past 30 years, type 1 men are living approximately 11 fewer years than their non-diabetic peers. For women, the years lost is even higher at 13…. Scottish researchers examined data from a prospective cohort of patients in Scotland with type 1 diabetes who were aged 20 years or older from 2008 through 2010 and were in a nationwide register (n=24,691 contributing 67,712 person-years and 1,043 deaths). Life expectancy at an attained age of 20 years was an additional 46.2 years among men with type 1 diabetes and 57.3 years among men without it, an estimated loss in life expectancy with diabetes of 11.1 years (95% CI, 10.1-12.1). Life expectancy from age 20 years was an additional 48.1 years among women with type 1 diabetes and 61.0 years among women without it, an estimated loss with diabetes of 12.9 years (95% CI, 11.7-14.1). Even among those with type 1 diabetes with an estimated glomerular filtration rate of 90 mL/min/1.73 m2 or higher, life expectancy was reduced (49.0 years in men, 53.1 years in women) giving an estimated loss from age 20 years of 8.3 years (95% CI, 6.5-10.1) for men and 7.9 years (95% CI, 5.5-10.3) for women. Overall, the largest percentage of the estimated loss in life expectancy was related to ischemic heart disease (36% in men, 31% in women) but death from diabetic coma or ketoacidosis was associated with the largest percentage of the estimated loss occurring before age 50 years (29.4% in men, 21.7% in women). The researchers concluded that, “Estimated life expectancy for patients with type 1 diabetes in Scotland based on data from 2008 through 2010 indicated an estimated loss of life expectancy at age 20 years of approximately 11 years for men and 13 years for women compared w Continue reading >>

3303.0 - Causes Of Death, Australia, 2013

3303.0 - Causes Of Death, Australia, 2013

+ Leading Causes of Death Diabetes mellitus is a chronic metabolic condition where glucose levels are too high within the bloodstream. This is due to insulin, a hormone that controls blood glucose levels, no longer being produced or not being produced in sufficient amounts by the body (Diabetes Australia). According to the Australian Health Survey 2011-12, 4.6% of persons aged 2 years and over (999,000 people) had some type of diabetes (excluding persons with gestational diabetes). This included 0.6% of persons with Type 1 diabetes and 3.9% of persons with Type 2 diabetes. Diabetes mellitus (E10-E14) was the sixth leading underlying cause of death of Australians in 2013, accounting for 4,328 or 2.9% of all deaths. The sex ratio for deaths due to diabetes was 113 male deaths per 100 female deaths. Type 1 and Type 2 Diabetes are the two main types of diabetes mellitus. Type 2 Diabetes has links to both genetic and lifestyle factors, whereas Type 1 Diabetes is not a lifestyle disease (Diabetes Australia). Over a 10 year time frame Type 2 Diabetes has increased by 37.5% as an underlying cause of death, rising from 1,428 deaths in 2004 to 1,964 in 2013. This is in contrast to Type 1 Diabetes which showed an 11.3% decrease in the same period, declining from 364 deaths in 2004 to 323 deaths in 2013. Table 2.3 shows the breakdown of deaths due to Type 1 Diabetes, Type 2 Diabetes, and Diabetes mellitus in total over a ten year time frame. (c) Type 1 Diabetes: E10 Insulin dependent diabetes mellitus. (d) Type 2 Diabetes: E11 Non-insulin dependent diabetes mellitus. (e) Total Diabetes: E10, E11; E12: Malnutrition related diabetes mellitus; E13: Other specified diabetes mellitus; E14: Unspecified diabetes mellitus. In 2013, for all deaths assigned an underlying cause of Type 2 Diab Continue reading >>

Type 1 Diabetes Linked To Lower Life Expectancy

Type 1 Diabetes Linked To Lower Life Expectancy

HealthDay Reporter today lose more than a decade of life to the chronic disease, despite improved treatment of both diabetes and its complications, a new Scottish study reports. Men with type 1 diabetes lose about 11 years of life expectancy compared to men without the disease. And, women with type 1 diabetes have their lives cut short by about 13 years, according to a report published in the Jan. 6 issue of the Journal of the American Medical Association. The findings "provide a more up-to-date quantification of how much type 1 diabetes cuts your life span now, in our contemporary era," said senior author Dr. Helen Colhoun, a clinical professor in the diabetes epidemiology unit of the University of Dundee School of Medicine in Scotland. Diabetes' impact on heart health appeared to be the largest single cause of lost years, according to the study. But, the researchers also found that type 1 diabetics younger than 50 are dying in large numbers from conditions caused by issues in management of the disease -- diabetic coma caused by critically low blood sugar, and ketoacidosis caused by a lack of insulin in the body. "These conditions really reflect the day-to-day challenge that people with type 1 diabetes continue to face, how to get the right amount of insulin delivered at the right time to deal with your blood sugar levels," Colhoun said. A second study, also in JAMA, suggested that some of these early deaths might be avoided with intensive blood sugar management. In that paper, researchers reduced patients' overall risk of premature death by about a third, compared with diabetics receiving standard care, by conducting multiple blood glucose tests throughout the day and constantly adjusting insulin levels to hit very specific blood sugar levels. "Across the board, indiv 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 >>

How Australians Die: Cause #5 – Diabetes

How Australians Die: Cause #5 – Diabetes

This is the final in the How Australians Die series that focuses on the country’s top five causes of death and how we can drive down rates of these illnesses. Previous series articles were on heart diseases and stroke, cancers, dementia and chronic lower respiratory diseases. Diabetes is rapidly emerging as a leading cause of death among Australians. It is also a leading cause of heart attacks, strokes, amputations, kidney failure, depression, dementia and severe infections – all of which themselves contribute to premature death. It never used to be this way. Thirty years ago, around 250,000 Australians had diabetes. Today that figure is around two million. Around the world in 2013, more than five million people between the ages of 20 and 79 died from diabetes, accounting for 8.4% of deaths among people in this age group. This translates to one death due to diabetes every six seconds. Tragically, nearly half of these were in people under 60. These figures likely underestimate the major role of diabetes in death as it frequently goes unreported as a cause of death. One study showed that only 35% to 40% of people with diabetes who died had the disease listed on their death certificate, while only about 10% to 15% had diabetes listed as the underlying cause of death. Which type of diabetes is worst? Diabetes is characterised by higher than normal levels of glucose in the blood, caused by having insufficient insulin production or function to keep glucose levels under control. This can come about if the immune system inadvertently destroys the insulin producing cells of the pancreas. This is called type 1 diabetes. It can occur at any age, but is most common in children and young adults. Ectopic fat – fat that accumulates outside the typical stores underneath your skin Continue reading >>

Incidence And Mortality Rates And Clinical Characteristics Of Type 1 Diabetes Among Children And Young Adults In Cochabamba, Bolivia

Incidence And Mortality Rates And Clinical Characteristics Of Type 1 Diabetes Among Children And Young Adults In Cochabamba, Bolivia

Incidence and Mortality Rates and Clinical Characteristics of Type 1 Diabetes among Children and Young Adults in Cochabamba, Bolivia 1Centro Vivir con Diabetes, Av. Simn Lpez, No. 375, Cochabamba, Bolivia 2International Diabetes Federation Life for a Child Program, Glebe, NSW 2037, Australia 3NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW 2006, Australia 4Diabetes NSW, Glebe, NSW 2037, Australia Correspondence should be addressed to Graham David Ogle ; [email protected] Received 29 May 2017; Revised 24 July 2017; Accepted 30 July 2017; Published 29 August 2017 Academic Editor: Konstantinos Papatheodorou Copyright 2017 Elizabeth Duarte Gmez et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. To determine incidence, mortality, and clinical status of youth with diabetes at the Centro Vivir con Diabetes, Cochabamba, Bolivia, with support from International Diabetes Federation Life for a Child Program. Methods. Incidence/mortality data analysis of all cases (<25 year (y)) diagnosed January 2005February 2017 and cross-sectional data (December 2015). Results. Over 12.2 years, 144 cases with type 1 diabetes (T1D) were diagnosed; 43.1% were male. Diagnosis age was 0.322.2 y; peak was 11-12 y. 11.1% were <5 y; 29.2%, 5<10 y; 43.1%, 10<15 y; 13.2%, 15<20 y; and 3.5%, 20<25 y. The youngest is being investigated for monogenic diabetes. Measured incidence in Cercado Province (Cochabamba Department) was 2.2/100,000 children < 15 y/y, with 80% ascertainment, giving total incidence of 2.7/100,000 children < 15 y/y. Two had died. Crude mortality rate was 2.3/1000 patient years. Cli Continue reading >>

Diabetes

Diabetes

Key facts The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014 (1). The global prevalence of diabetes* among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014 (1). Diabetes prevalence has been rising more rapidly in middle- and low-income countries. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. In 2015, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012**. Almost half of all deaths attributable to high blood glucose occur before the age of 70 years. WHO projects that diabetes will be the seventh leading cause of death in 2030 (1). Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes. Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications. What is diabetes? Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels. In 2014, 8.5% of adults aged 18 years and older had diabetes. In 2015, diabetes was the direct cause of 1.6 million deaths and in 2012 high blood glucose was the cause of another 2.2 million deaths. Type 1 diabetes Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is charact 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 >>

Type 1 Diabetes Mortality Rate Higher In Uk Than Most Of Europe

Type 1 Diabetes Mortality Rate Higher In Uk Than Most Of Europe

Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why people with diabetes are advised to avoid sources of dietary sugar. The good news is for very many people with type 2 diabetes this is all they have to do to stay well. If you can keep your blood sugar lower by avoiding dietary sugar, likely you will never need long-term medication. Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over 40. However, type 2 diabetes is now becoming more common in young adults, teens and children and accounts for roughly 90% of all diabetes cases worldwide. How serious is type 2 diabetes? Type 2 diabetes is a serious medical condition that often requires the use of anti-diabetic medication, or insulin to keep blood sugar levels under control. However, the development of type 2 diabetes and its side effects (complications) can be prevented if detected and treated at an early stage. In recent years, it has become apparent that many people with type 2 diabetes are able to reverse diabetes through methods including low-carb diets, very-low-calorie diets and exercise. For guidance on healthy eating to improve blood glucose levels and weight and to fight back against in Continue reading >>

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