Mortality risk in type 2 diabetes
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All-Cause and Cardiovascular Mortality Risk in Type 2 Diabetes
People with type 2 diabetes have a higher risk of death from all causes and from cardiovascular disease compared to the general population. This risk is especially pronounced in those diagnosed at a younger age, with poor glycemic control, or with kidney complications. The risk of death is not uniform and varies based on age at diagnosis, disease duration, and the presence of other health conditions such as hypertension, high cholesterol, and chronic kidney disease Tancredi2015Rawshani2018Huo2018+5 MORE.
Impact of Age at Diagnosis and Disease Duration
Younger age at diagnosis of type 2 diabetes is strongly linked to a higher risk of both all-cause and cardiovascular mortality. For example, individuals diagnosed before age 40 have more than double the risk of death compared to those diagnosed after age 60. The risk of death from cardiovascular causes is even higher in those with early-onset diabetes. Longer duration of diabetes also increases mortality risk, and those diagnosed at a younger age experience a greater loss in life expectancy—up to a decade less if diagnosed in adolescence Huo2018Sattar2019Zhang2024+1 MORE.
Role of Glycemic Control and Other Risk Factors
Poor glycemic control (high HbA1c), smoking, high LDL cholesterol, high blood pressure, and the presence of albuminuria (a marker of kidney damage) all contribute to increased mortality risk in type 2 diabetes. However, patients who manage to keep these risk factors within target ranges can reduce their excess risk of death, heart attack, and stroke to levels similar to the general population. Among these risk factors, poor glycemic control is the strongest predictor of stroke and heart attack, while smoking is the strongest predictor of death McEwen2012Rawshani2018.
Kidney Disease and Mortality in Type 2 Diabetes
Kidney disease is a major driver of increased mortality in people with type 2 diabetes. Those with both diabetes and kidney disease have a much higher risk of death compared to those with diabetes alone or the general population. Chronic kidney disease, in particular, significantly raises the risk of all-cause and cardiovascular mortality Tancredi2015Arnold2018Afkarian2013.
Cancer and Other Causes of Death
Type 2 diabetes is also associated with a higher risk of developing and dying from certain cancers, especially liver, pancreatic, and uterine cancers. The risk of post-cancer mortality is higher in people with diabetes, and cancer may become the leading cause of death in this population in the future .
Socioeconomic and Demographic Predictors
Other factors that increase mortality risk in type 2 diabetes include older age, male sex, white race, lower income, smoking, insulin treatment, and the presence of other health conditions such as heart disease and heart failure. These factors can be used to predict mortality risk and guide patient management .
Conclusion
Mortality risk in type 2 diabetes is influenced by age at diagnosis, disease duration, glycemic control, kidney function, and the presence of other health conditions. Early-onset diabetes and longer disease duration are linked to higher mortality and greater loss of life expectancy. Effective management of blood sugar, blood pressure, cholesterol, and kidney health can help reduce this risk, highlighting the importance of early prevention and comprehensive care in people with type 2 diabetes Tancredi2015Rawshani2018Huo2018+5 MORE.
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