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These studies suggest that mortality rates in type 1 diabetes patients are higher than in the general population, with increased risks particularly for women, those with renal disease, and those experiencing acute or chronic complications, although long-term survival has improved due to advances in care.
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Type 1 diabetes (T1D) significantly increases the risk of mortality compared to the general population. The International Diabetes Federation (IDF) Diabetes Atlas estimates that the prevalence of T1D in children and adolescents is increasing globally, with higher mortality rates observed in less-developed countries due to limited healthcare resources.
Research indicates that women with T1D have a higher risk of mortality compared to men. A meta-analysis found that women with T1D have a 40% greater excess risk of all-cause mortality and twice the excess risk of fatal and nonfatal vascular events compared to men. This sex disparity is particularly pronounced in cardiovascular and renal disease-related deaths.
Long-term studies have shown that mortality rates in T1D patients have improved over the decades. For instance, the Allegheny County Registry study observed a significant improvement in survival rates for patients diagnosed between 1975-1979 compared to those diagnosed between 1965-1969, likely due to advancements in diabetes management such as HbA1c testing and home blood glucose monitoring. Similarly, a study from the UK General Practice Research Database reported that despite advances in care, mortality rates in T1D patients remain significantly higher than in the non-diabetic population, with cardiovascular disease being the predominant cause of death.
The primary causes of death in T1D patients vary with age and duration of the disease. In younger patients, acute metabolic complications are the leading cause of death, while in older patients, cardiovascular disease becomes more prevalent. A study from the Steno Diabetes Centre found that nephropathy is a major driver of excess mortality in T1D patients, and those without renal disease have mortality rates comparable to the general population .
Recent studies have highlighted emerging trends in mortality causes among T1D patients. For example, a study in Yorkshire, UK, found that drug misuse, including insulin misuse, is an increasing cause of death among young T1D patients. Additionally, the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study showed that intensive diabetes management can significantly reduce mortality rates, bringing them closer to those of the general population.
While mortality rates in T1D patients have improved over the years due to better diabetes management and healthcare advancements, they remain higher than in the general population. Women and individuals with renal complications are particularly at risk. Continuous efforts in improving diabetes care and addressing emerging risk factors are essential to further reduce mortality rates in T1D patients.
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