Mortality rate of diabetes type 2
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Mortality Rate of Type 2 Diabetes: A Comprehensive Analysis
Overview of Mortality Rates in Type 2 Diabetes
Type 2 diabetes mellitus (T2DM) is associated with a significant increase in mortality risk. Studies have shown that mortality rates among individuals with T2DM can vary widely based on several factors, including age, glycemic control, presence of comorbidities, and geographic location.
Variability in Mortality Rates
Randomized Controlled Trials (RCTs) Insights
An analysis of 22 randomized controlled trials (RCTs) involving 91,842 patients with T2DM revealed a substantial variation in annualized mortality rates, ranging from 0.28 to 8.24 per 100 patient-years. The highest mortality rates were observed in patients with chronic kidney disease, defined by either a decline in renal function or the presence of proteinuria.
Population-Based Studies in Latin America
In Latin America, the proportion of all-cause mortality attributable to T2DM increased from 12.2% to 16.9% in men and from 14.5% to 19.3% in women between 1985 and 2014. In 2019, the absolute number of deaths attributable to T2DM was 349,787 in men and 330,414 in women, with the highest death rates observed in Saint Kitts and Nevis, Guyana, and Haiti.
Factors Influencing Mortality
Age and Glycemic Control
A study from the Swedish National Diabetes Register indicated that the excess risk of death from any cause and cardiovascular causes increased with younger age, worse glycemic control, and greater severity of renal complications. For instance, patients younger than 55 years with good glycemic control had a hazard ratio for death of 1.92 compared to controls, whereas the hazard ratio was 0.95 for those older than 75 years.
Diagnosis at Older Age
A systematic review of observational studies found that the increased mortality associated with a diagnosis of T2DM at an older age is lower than that reported for the general older diabetic population. The relative risks of increased mortality for men diagnosed between the ages of 60 and 70 were 1.38, and 1.13 for those diagnosed at 70 years or older. A similar pattern was observed in women.
Sex-Specific Differences
A meta-analysis revealed that the effect of T2DM on all-cause and coronary heart disease (CHD) mortality is approximately 17% and 97% greater, respectively, for women than for men. The pooled hazard ratios for all-cause mortality were 2.33 for women and 1.91 for men with T2DM compared to their healthy counterparts.
Ethnic and Regional Variations
Ethnic Subgroups in England
A cohort study in England found that at age 40, white men with T2DM lost 5 years of life and white women lost 6 years compared to those without diabetes. In contrast, South Asians and blacks with T2DM lost between 1 and 2 years. Interestingly, South Asians older than 65 years with T2DM had up to 1.1 years longer life expectancy than their non-diabetic counterparts.
Trends in the United Kingdom
A study examining trends from 1996 to 2006 in the United Kingdom showed a consistent decrease in relative mortality for individuals with T2DM. The age-standardized all-cause mortality rate decreased by 0.82 per 1,000 per year in men and by 0.49 in women. Relative mortality for subjects diagnosed in 2006 was 26% lower than that for those diagnosed in 2001.
Conclusion
The mortality rate of type 2 diabetes varies significantly based on age, glycemic control, presence of comorbidities, and geographic and ethnic factors. While some populations show a higher risk, others have seen improvements in relative mortality over time. These findings underscore the importance of tailored management strategies to address the diverse needs of individuals with T2DM.
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