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Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes.

Artikel i vetenskaplig tidskrift
Författare Aidin Rawshani
Araz Rawshani
Stefan Franzén
Björn Eliasson
Ann-Marie Svensson
Mervete Miftaraj
Darren K McGuire
Naveed Sattar
Annika Rosengren
Soffia Gudbjörnsdottir
Publicerad i The New England journal of medicine
Volym 376
Nummer/häfte 15
Sidor 1407-1418
ISSN 1533-4406
Publiceringsår 2017
Publicerad vid Institutionen för medicin, avdelningen för molekylär och klinisk medicin
Sidor 1407-1418
Språk en
Länkar dx.doi.org/10.1056/NEJMoa1608664
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Adolescent, Adult, Age of Onset, Aged, Cardiovascular Diseases, epidemiology, etiology, mortality, Diabetes Mellitus, Type 1, complications, mortality, Diabetes Mellitus, Type 2, complications, mortality, Female, Hospitalization, trends, Humans, Incidence, Male, Middle Aged, Mortality, trends, Proportional Hazards Models, Registries, Risk Factors, Sweden, epidemiology
Ämneskategorier Diabetologi, Kardiovaskulär medicin

Sammanfattning

Long-term trends in excess risk of death and cardiovascular outcomes have not been extensively studied in persons with type 1 diabetes or type 2 diabetes.We included patients registered in the Swedish National Diabetes Register from 1998 through 2012 and followed them through 2014. Trends in deaths and cardiovascular events were estimated with Cox regression and standardized incidence rates. For each patient, controls who were matched for age, sex, and county were randomly selected from the general population.Among patients with type 1 diabetes, absolute changes during the study period in the incidence rates of sentinel outcomes per 10,000 person-years were as follows: death from any cause, -31.4 (95% confidence interval [CI], -56.1 to -6.7); death from cardiovascular disease, -26.0 (95% CI, -42.6 to -9.4); death from coronary heart disease, -21.7 (95% CI, -37.1 to -6.4); and hospitalization for cardiovascular disease, -45.7 (95% CI, -71.4 to -20.1). Absolute changes per 10,000 person-years among patients with type 2 diabetes were as follows: death from any cause, -69.6 (95% CI, -95.9 to -43.2); death from cardiovascular disease, -110.0 (95% CI, -128.9 to -91.1); death from coronary heart disease, -91.9 (95% CI, -108.9 to -75.0); and hospitalization for cardiovascular disease, -203.6 (95% CI, -230.9 to -176.3). Patients with type 1 diabetes had roughly 40% greater reduction in cardiovascular outcomes than controls, and patients with type 2 diabetes had roughly 20% greater reduction than controls. Reductions in fatal outcomes were similar in patients with type 1 diabetes and controls, whereas patients with type 2 diabetes had smaller reductions in fatal outcomes than controls.In Sweden from 1998 through 2014, mortality and the incidence of cardiovascular outcomes declined substantially among persons with diabetes, although fatal outcomes declined less among those with type 2 diabetes than among controls. (Funded by the Swedish Association of Local Authorities and Regions and others.).

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