The significance of chronic kidney disease, heart failure and cardiovascular disease for mortality in type 1 diabetes: nationwide observational study
Abstract People with type 1 diabetes have a substantially increased risk of premature death. This nationwide, register-based cohort study evaluated the significance of risk factors and previous cardiovascular disease (CVD), heart failure and chronic kidney disease (CKD), for mortality in type 1 diab...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-10-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-22932-4 |
| _version_ | 1797991761171185664 |
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| author | Björn Eliasson Lovisa Lyngfelt Sven-Olof Strömblad Stefan Franzén Katarina Eeg-Olofsson |
| author_facet | Björn Eliasson Lovisa Lyngfelt Sven-Olof Strömblad Stefan Franzén Katarina Eeg-Olofsson |
| author_sort | Björn Eliasson |
| collection | DOAJ |
| description | Abstract People with type 1 diabetes have a substantially increased risk of premature death. This nationwide, register-based cohort study evaluated the significance of risk factors and previous cardiovascular disease (CVD), heart failure and chronic kidney disease (CKD), for mortality in type 1 diabetes. Nationwide, longitudinal, register-based cohort study. Patients (n = 36,303) listed in the Swedish National Diabetes Register between January 1 2015 and December 31 2017 were included and followed until December 31, 2018. Data were retrieved from national health registries through each patient's unique identifier, to capture data on clinical characteristics, outcomes, or deaths, to describe mortality rates in risk groups. The mean follow-up time was 3.3 years, with 119,800 patient years of observation and 1127 deaths, corresponding to a crude overall mortality of 0.92% deaths/year. Statistically significant increased risk in multivariate analyzes was found in older age groups, in men, and in underweight or people with normal BMI, high HbA1c or blood pressure. A history of CVD, albuminuria and advanced stages of CKD was associated with an increased risk of mortality. Each combination of these conditions further increased the risk of mortality. These results emphasize the importance of risk factors and cardiovascular and renal diabetes complications. People with a combination of CKD, CVD, and heart failure, exhibit a markedly increased risk of dying prematurely. These findings provide strong arguments for optimized and individualized treatment of these groups of people with type 1 diabetes in clinical everyday life. |
| first_indexed | 2024-04-11T08:57:25Z |
| format | Article |
| id | doaj.art-89865aa2e7ca4c08b45407b1c3ad94c0 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-11T08:57:25Z |
| publishDate | 2022-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-89865aa2e7ca4c08b45407b1c3ad94c02022-12-22T04:33:09ZengNature PortfolioScientific Reports2045-23222022-10-011211910.1038/s41598-022-22932-4The significance of chronic kidney disease, heart failure and cardiovascular disease for mortality in type 1 diabetes: nationwide observational studyBjörn Eliasson0Lovisa Lyngfelt1Sven-Olof Strömblad2Stefan Franzén3Katarina Eeg-Olofsson4Department of Medicine, Sahlgrenska University HospitalInstitute of Medicine, University of Gothenburg, Sahlgrenska University HospitalPrimary Care Global Business Unit, SanofiHealth Metrics, School of Public Health and Community Medicine, University of GothenburgDepartment of Medicine, Sahlgrenska University HospitalAbstract People with type 1 diabetes have a substantially increased risk of premature death. This nationwide, register-based cohort study evaluated the significance of risk factors and previous cardiovascular disease (CVD), heart failure and chronic kidney disease (CKD), for mortality in type 1 diabetes. Nationwide, longitudinal, register-based cohort study. Patients (n = 36,303) listed in the Swedish National Diabetes Register between January 1 2015 and December 31 2017 were included and followed until December 31, 2018. Data were retrieved from national health registries through each patient's unique identifier, to capture data on clinical characteristics, outcomes, or deaths, to describe mortality rates in risk groups. The mean follow-up time was 3.3 years, with 119,800 patient years of observation and 1127 deaths, corresponding to a crude overall mortality of 0.92% deaths/year. Statistically significant increased risk in multivariate analyzes was found in older age groups, in men, and in underweight or people with normal BMI, high HbA1c or blood pressure. A history of CVD, albuminuria and advanced stages of CKD was associated with an increased risk of mortality. Each combination of these conditions further increased the risk of mortality. These results emphasize the importance of risk factors and cardiovascular and renal diabetes complications. People with a combination of CKD, CVD, and heart failure, exhibit a markedly increased risk of dying prematurely. These findings provide strong arguments for optimized and individualized treatment of these groups of people with type 1 diabetes in clinical everyday life.https://doi.org/10.1038/s41598-022-22932-4 |
| spellingShingle | Björn Eliasson Lovisa Lyngfelt Sven-Olof Strömblad Stefan Franzén Katarina Eeg-Olofsson The significance of chronic kidney disease, heart failure and cardiovascular disease for mortality in type 1 diabetes: nationwide observational study Scientific Reports |
| title | The significance of chronic kidney disease, heart failure and cardiovascular disease for mortality in type 1 diabetes: nationwide observational study |
| title_full | The significance of chronic kidney disease, heart failure and cardiovascular disease for mortality in type 1 diabetes: nationwide observational study |
| title_fullStr | The significance of chronic kidney disease, heart failure and cardiovascular disease for mortality in type 1 diabetes: nationwide observational study |
| title_full_unstemmed | The significance of chronic kidney disease, heart failure and cardiovascular disease for mortality in type 1 diabetes: nationwide observational study |
| title_short | The significance of chronic kidney disease, heart failure and cardiovascular disease for mortality in type 1 diabetes: nationwide observational study |
| title_sort | significance of chronic kidney disease heart failure and cardiovascular disease for mortality in type 1 diabetes nationwide observational study |
| url | https://doi.org/10.1038/s41598-022-22932-4 |
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