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Mortality in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE)
Mary Ann Banerji1, John B Buse2, Naji Younes3
1Division of Endocrinology and Department of Medicine, State University of New York Downstate Medical Center, Kings County Hospital Center, Brooklyn, NY.
Diabetes Care
|January 22, 2024
Summary
Mortality rates were low in the Glycemia Reduction Approaches in Diabetes (GRADE) study for type 2 diabetes patients. Cardiovascular disease and cancer were the leading causes of death, highlighting varied health risks.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Oncology
Background:
- The Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) investigated mortality outcomes.
- Focus was on individuals with type 2 diabetes diagnosed within 10 years, excluding those with recent cardiovascular events or cancer.
Purpose of the Study:
- To assess overall mortality rates and major causes of death.
- To identify factors associated with mortality in this specific diabetic population.
Main Methods:
- Follow-up averaged 5 years, with central adjudication of causes of death, masked to treatment assignment.
- Baseline covariates and 10-year Framingham Risk Score were analyzed for associations with mortality.
Main Results:
- The overall mortality rate was low at 0.59 per 100 participant-years.
- Factors associated with death included older age, male sex, hypertension, smoking history, and moderate albuminuria.
- Cardiovascular causes (38.6%) and cancer (26.8%) were the most frequent causes of death, with no treatment group differences.
Conclusions:
- In individuals with relatively short-duration diabetes, causes of death are diverse.
- Clinical attention should extend beyond cardiovascular risks to encompass other health threats.
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