Young adult patients with type 1 diabetes have a higher risk of mortality than those of similar age with type 2 diabetes

A nationwide analysis in Hungary

Zoltán Kiss, György Rokszin, Zsolt Abonyi-Tóth, G. Jermendy, Péter Kempler, László Barkai, I. Wittmann

Research output: Contribution to journalArticle

Abstract

BACKGROUND: There are few papers comparing complications of type 1 diabetes with those of a similarly young age with type 2 diabetes. The aim of our nationwide study was to compare the risks of mortality and morbidities between the two types of diabetes (age ≤ 40). METHODS: We identified all young adult patients with type 1 diabetes who were recorded in the database of the Hungarian National Health Insurance Fund between 2001 and 2014 (n = 11 863) and compared them with a population of similar age with young adult type 2 diabetes (n = 47 931). The incidence of all-cause mortality, myocardial infarction, stroke, any type of cancer, diabetic ketoacidosis, and hypoglycemia was followed from the onset of diabetes to the date of death or end of study period. RESULTS: The risks of all-cause mortality were significantly higher in patients with type 1 compared with patients with type 2 diabetes (hazard ratio, 95%CI; 2.17, 1.95-2.41; P <.0001). The risks of myocardial infarction (0.90, 0.71-1.13; P = 0.36) and stroke (1.06, 0.87-1.29; P =.582) were not significantly different in type 1 compared with type 2. In contrast, the risk of cancer (1.35, 1.15-1.59; P =.0003), dialysis (2.20, 1.76-2.75; P <.0001), hypoglycemia (7.70, 6.45-9.18; P <.0001), and ketoacidosis (22.12, 19.60-25.00; P <.0001) was higher among patients with type 1 compared with those with type 2 diabetes. CONCLUSIONS: A comparatively higher incidence of diabetic ketoacidosis and hypoglycemia and higher risk of cancer and dialysis in patients with type 1 diabetes than in those with type 2 may play a role in the higher risk of mortality.

Original languageEnglish
Article numbere3190
JournalDiabetes/Metabolism Research and Reviews
DOIs
Publication statusPublished - Jan 1 2019

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Hungary
Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Young Adult
Mortality
Hypoglycemia
Diabetic Ketoacidosis
Dialysis
Stroke
Myocardial Infarction
Neoplasms
Ketosis
Incidence
National Health Programs
Databases
Morbidity
Population

Keywords

  • all-cause mortality
  • cardiovascular morbidity
  • diabetic ketoacidosis
  • hypoglycemia
  • type 1 diabetes
  • type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Young adult patients with type 1 diabetes have a higher risk of mortality than those of similar age with type 2 diabetes : A nationwide analysis in Hungary. / Kiss, Zoltán; Rokszin, György; Abonyi-Tóth, Zsolt; Jermendy, G.; Kempler, Péter; Barkai, László; Wittmann, I.

In: Diabetes/Metabolism Research and Reviews, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: There are few papers comparing complications of type 1 diabetes with those of a similarly young age with type 2 diabetes. The aim of our nationwide study was to compare the risks of mortality and morbidities between the two types of diabetes (age ≤ 40). METHODS: We identified all young adult patients with type 1 diabetes who were recorded in the database of the Hungarian National Health Insurance Fund between 2001 and 2014 (n = 11 863) and compared them with a population of similar age with young adult type 2 diabetes (n = 47 931). The incidence of all-cause mortality, myocardial infarction, stroke, any type of cancer, diabetic ketoacidosis, and hypoglycemia was followed from the onset of diabetes to the date of death or end of study period. RESULTS: The risks of all-cause mortality were significantly higher in patients with type 1 compared with patients with type 2 diabetes (hazard ratio, 95{\%}CI; 2.17, 1.95-2.41; P <.0001). The risks of myocardial infarction (0.90, 0.71-1.13; P = 0.36) and stroke (1.06, 0.87-1.29; P =.582) were not significantly different in type 1 compared with type 2. In contrast, the risk of cancer (1.35, 1.15-1.59; P =.0003), dialysis (2.20, 1.76-2.75; P <.0001), hypoglycemia (7.70, 6.45-9.18; P <.0001), and ketoacidosis (22.12, 19.60-25.00; P <.0001) was higher among patients with type 1 compared with those with type 2 diabetes. CONCLUSIONS: A comparatively higher incidence of diabetic ketoacidosis and hypoglycemia and higher risk of cancer and dialysis in patients with type 1 diabetes than in those with type 2 may play a role in the higher risk of mortality.",
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author = "Zolt{\'a}n Kiss and Gy{\"o}rgy Rokszin and Zsolt Abonyi-T{\'o}th and G. Jermendy and P{\'e}ter Kempler and L{\'a}szl{\'o} Barkai and I. Wittmann",
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AU - Kiss, Zoltán

AU - Rokszin, György

AU - Abonyi-Tóth, Zsolt

AU - Jermendy, G.

AU - Kempler, Péter

AU - Barkai, László

AU - Wittmann, I.

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N2 - BACKGROUND: There are few papers comparing complications of type 1 diabetes with those of a similarly young age with type 2 diabetes. The aim of our nationwide study was to compare the risks of mortality and morbidities between the two types of diabetes (age ≤ 40). METHODS: We identified all young adult patients with type 1 diabetes who were recorded in the database of the Hungarian National Health Insurance Fund between 2001 and 2014 (n = 11 863) and compared them with a population of similar age with young adult type 2 diabetes (n = 47 931). The incidence of all-cause mortality, myocardial infarction, stroke, any type of cancer, diabetic ketoacidosis, and hypoglycemia was followed from the onset of diabetes to the date of death or end of study period. RESULTS: The risks of all-cause mortality were significantly higher in patients with type 1 compared with patients with type 2 diabetes (hazard ratio, 95%CI; 2.17, 1.95-2.41; P <.0001). The risks of myocardial infarction (0.90, 0.71-1.13; P = 0.36) and stroke (1.06, 0.87-1.29; P =.582) were not significantly different in type 1 compared with type 2. In contrast, the risk of cancer (1.35, 1.15-1.59; P =.0003), dialysis (2.20, 1.76-2.75; P <.0001), hypoglycemia (7.70, 6.45-9.18; P <.0001), and ketoacidosis (22.12, 19.60-25.00; P <.0001) was higher among patients with type 1 compared with those with type 2 diabetes. CONCLUSIONS: A comparatively higher incidence of diabetic ketoacidosis and hypoglycemia and higher risk of cancer and dialysis in patients with type 1 diabetes than in those with type 2 may play a role in the higher risk of mortality.

AB - BACKGROUND: There are few papers comparing complications of type 1 diabetes with those of a similarly young age with type 2 diabetes. The aim of our nationwide study was to compare the risks of mortality and morbidities between the two types of diabetes (age ≤ 40). METHODS: We identified all young adult patients with type 1 diabetes who were recorded in the database of the Hungarian National Health Insurance Fund between 2001 and 2014 (n = 11 863) and compared them with a population of similar age with young adult type 2 diabetes (n = 47 931). The incidence of all-cause mortality, myocardial infarction, stroke, any type of cancer, diabetic ketoacidosis, and hypoglycemia was followed from the onset of diabetes to the date of death or end of study period. RESULTS: The risks of all-cause mortality were significantly higher in patients with type 1 compared with patients with type 2 diabetes (hazard ratio, 95%CI; 2.17, 1.95-2.41; P <.0001). The risks of myocardial infarction (0.90, 0.71-1.13; P = 0.36) and stroke (1.06, 0.87-1.29; P =.582) were not significantly different in type 1 compared with type 2. In contrast, the risk of cancer (1.35, 1.15-1.59; P =.0003), dialysis (2.20, 1.76-2.75; P <.0001), hypoglycemia (7.70, 6.45-9.18; P <.0001), and ketoacidosis (22.12, 19.60-25.00; P <.0001) was higher among patients with type 1 compared with those with type 2 diabetes. CONCLUSIONS: A comparatively higher incidence of diabetic ketoacidosis and hypoglycemia and higher risk of cancer and dialysis in patients with type 1 diabetes than in those with type 2 may play a role in the higher risk of mortality.

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KW - cardiovascular morbidity

KW - diabetic ketoacidosis

KW - hypoglycemia

KW - type 1 diabetes

KW - type 2 diabetes

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