Related Experiment Video
Updated: Feb 23, 2026
Author Spotlight: Understanding Retinal Vessel Resilience and Disease Progression
Published on: January 12, 2024
Excess all-cause mortality before age 30 in childhood onset type 1 diabetes: data from the Brecon Group Cohort in
Diana R Wasag1, John W Gregory2, Colin Dayan3
1Diabetes Research Group, Wrexham Academic Unit, Bangor University, Wrexham, UK.
Insights
Young people diagnosed with type 1 diabetes before age 15 face a high mortality risk before age 30, with ketoacidosis being the primary cause of death. Chronic complications were not a factor in this age group.
Area of Science:
- Pediatrics
- Endocrinology
- Public Health
Background:
- Long-term outcomes in type 1 diabetes are crucial for evaluating evolving pediatric clinical care.
- Understanding mortality trends in young type 1 diabetes patients informs public health strategies.
Purpose of the Study:
- To determine mortality rates and causes before age 30 in individuals diagnosed with type 1 diabetes before age 15.
- To assess if mortality risk has changed over time in this cohort.
Main Methods:
- A prospective register (Brecon Cohort) of type 1 diabetes cases diagnosed before age 15 in Wales was established in 1995.
- Mortality rates were compared to general populations in Wales and England using patient-years exposure.
- Causes of death were verified through death certificates and clinician reports.
Main Results:
- The standardized mortality ratio was 2.91, with no significant change over time.
- Most deaths occurred between ages 15 and 30, slightly younger than the general population.
- Ketoacidosis was the leading cause of death; hypoglycemia also contributed. Chronic complications were not a cause of death in this cohort.
Conclusions:
- Despite advancements in care, mortality risk remains elevated for young adults with childhood-onset type 1 diabetes.
- Mortality occurs before the typical onset of chronic diabetes complications.
- Age at diagnosis influences mortality risk, with later diagnosis associated with higher risk.
Background:
Long-term outcomes in young people with type 1 diabetes continue to be of interest, and may help evaluate the effects of changes to the clinical care of children that have occurred in recent decades.
Aims:
To identify mortality and its causes before age 30 years in patients developing type 1 diabetes before age 15 years.
Methods:
Since 1995, paediatricians in Wales have compiled a prospective register of incident cases of type 1 diabetes occurring before age 15 years in Wales (the Brecon Cohort). Their subsequent mortality rates were compared with mortality in the general populations of Wales and England using the patient-years exposure method. Causes of death were ascertained from death certificates and from clinicians.
Results:
The standardised mortality ratio for young people with type 1 diabetes in Wales was 2.91 with no clear evidence of improvement or worsening of mortality risk over time. Most deaths occurred between ages 15 and 30 years although at a slightly younger age than in the general population. There were more deaths with increasing age at diagnosis of diabetes. Ketoacidosis remains the most common cause of death before age 30 years. Hypoglycaemia was difficult to ascertain with certainty but also caused some deaths. In this age group, chronic complications of diabetes were not a cause of mortality.
Conclusions:
Despite the developments in clinical care in recent years, the mortality risk for people developing type 1 diabetes in childhood remains high in young adult life before the onset of chronic complications.
Related Concept Videos
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
01:22Diabetes Mellitus: Type 2 and Gestational
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
01:36Carbohydrate Metabolism
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
01:19Psychoneuroimmunology: Diabetes and Cancer