All-cause mortality among primary care patients with type 2 diabetes: a prospective cohort study

This research aimed to investigate the factors contributing to mortality in patients with type 2 diabetes (T2D) to identify the primary determinants that exacerbate mortality risks in this population.

In this cohort study, 297 T2D patients from an urban Spanish population were monitored over 49 months to assess survival. The study collected sociodemographic and clinical data, including cardiovascular risk factors and initial treatments, to examine their impact on patient survival.

Of the initial 291 T2D patients, 60.1% were over 65y, with a male majority (53.3%) and average T2D duration of 8.8 years. In the 4-year follow-up, 15.4% of the patients died, predominantly due to cardiovascular disease (33.3%) and cancer (31.1%). In multivariate analysis, age (Hazard Ratio [HR] 1.169, p = 0.002) and body mass index (BMI; HR 0.807, p = 0.039) were identified as potential modulators of such relationships.

The present study reveals that cardiovascular disease, closely followed by cancer, are the leading causes of mortality in a Spanish T2D patients' cohort over a 4-year follow-up. In addition to age - which, as expected, was clearly associated with higher mortality - BMI was inversely associated with mortality, supporting the existence of an obesity paradox in T2D.