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Mortality in type 1 diabetes diagnosed in childhood in Northern Ireland during 1989-2012: A population-based cohort

Eileen Morgan1,2, Catherine R Black1,2, Noina Abid3

  • 1UKCRC Centre of Excellence for Public Health NI, Queen's University Belfast, Belfast, UK.

Pediatric Diabetes
|May 27, 2017
PubMed

Insights

Individuals diagnosed with type 1 diabetes before age 15 face triple the mortality risk of the general population. Over half of deaths are linked to diabetes complications, highlighting the need for improved management.

Area of Science:

  • Endocrinology
  • Public Health
  • Epidemiology

Background:

  • Type 1 diabetes (T1D) is a chronic condition requiring lifelong management.
  • Long-term mortality data in childhood-onset T1D is crucial for understanding disease burden and improving care.
  • Previous studies may not fully capture mortality trends in contemporary cohorts.

Purpose of the Study:

  • To determine long-term mortality rates and causes of death in individuals diagnosed with T1D before age 15 in Northern Ireland.
  • To compare observed mortality in this cohort with expected deaths in the general population.
  • To identify specific causes of death and risk factors associated with T1D in this population.

Main Methods:

  • A cohort of 3129 patients diagnosed with T1D before age 15 was established using the Northern Ireland Childhood Diabetes Register.
  • The cohort was linked to national death registrations, with causes of death coded using ICD-9 or ICD-10.
  • Standardized Mortality Ratios (SMRs) were calculated, adjusting for sex, age, time since diagnosis, and calendar period.

Main Results:

  • The cohort experienced 39,764 person-years of follow-up, with 59 deaths observed versus 19.9 expected, yielding an overall SMR of 296 (95% CI 229-382).
  • Women faced a significantly higher excess mortality risk (SMR 535) compared to men (SMR 203).
  • Over half (56%) of deaths were attributed to diabetes-related complications, primarily acute (n=24) and late (n=6) complications.

Conclusions:

  • Individuals with childhood-onset T1D have a three-fold increased mortality risk compared to the general population.
  • Diabetes-related acute and chronic complications are the leading causes of death in this cohort.
  • These findings underscore the critical need for enhanced diabetes management strategies to reduce premature mortality in young people with T1D.
Abstract

Keywords:
mortalitystandardized mortality ratiotype 1 diabetes

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