Diabetes Metab J.  2019 Jun;43(3):319-341. 10.4093/dmj.2018.0060.

Diabetes Mellitus and Cause-Specific Mortality: A Population-Based Study

Affiliations
  • 1School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China. senli@connect.hku.hk
  • 2Department of Physiology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong.
  • 3Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China.
  • 4School of Management, Beijing University of Chinese Medicine, Beijing, China.
  • 5Department of Biostatistics and Bioinformatics, Winship Cancer Institute, Emory University, Atlanta, GA, USA.

Abstract

BACKGROUND
To investigate whether diabetes contributes to mortality for major types of diseases.
METHODS
Six National Health and Nutrition Examination Survey data cycles (1999 to 2000, 2001 to 2002, 2003 to 2004, 2005 to 2006, 2007 to 2008, and 2009 to 2010) and their linked mortality files were used. A population of 15,513 participants was included according to the availability of diabetes and mortality status.
RESULTS
Participants with diabetes tended to have higher all-cause mortality and mortality due to cardiovascular disease, cancer, chronic lower respiratory diseases, cerebrovascular disease, influenza and pneumonia, and kidney disease. Confounder-adjusted Cox proportional hazard models showed that both diagnosed diabetes category (yes or no) and diabetes status (diabetes, prediabetes, or no diabetes) were associated with all-cause mortality and with mortality due to cardiovascular disease, chronic lower respiratory diseases, influenza and pneumonia, and kidney disease. No associations were found for cancer-, accidents-, or Alzheimer's disease-related mortality.
CONCLUSION
The current study's findings provide epidemiological evidence that diagnosed diabetes at the baseline is associated with increased mortality risk due to cardiovascular disease, chronic lower respiratory diseases, influenza and pneumonia, and kidney disease, but not with cancer or Alzheimer's disease.

Keyword

Diabetes complications; Diabetes mellitus; Mortality

MeSH Terms

Alzheimer Disease
Cardiovascular Diseases
Cerebrovascular Disorders
Diabetes Complications
Diabetes Mellitus*
Influenza, Human
Kidney Diseases
Mortality*
Nutrition Surveys
Pneumonia
Prediabetic State
Proportional Hazards Models

Figure

  • Fig. 1 Adjusted Kaplan-Meier survival curves for cumulative all-cause and other mortality according to diagnosed diabetes category: (A) all-cause, (B) cardiovascular disease (CVD), (C) cancer, (D) chronic lower respiratory disease (CLRD), (E) accidents, (F) cerebrovascular disease (CeVD), (G) Alzheimer's disease (AD), (H) flu & pneumonia, and (I) kidney disease.

  • Fig. 2 Adjusted Kaplan-Meier survival curves for cumulative all-cause and other mortality according to diabetes status category: (A) all-cause, (B) cardiovascular disease (CVD), (C) cancer, (D) chronic lower respiratory disease (CLRD), (E) accidents, (F) cerebrovascular disease (CeVD), (G) Alzheimer's disease (AD), (H) flu & pneumonia, and (I) kidney disease.


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Diabetes Metab J. 2019;43(6):733-743.    doi: 10.4093/dmj.2019.0177.

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