Excess mortality in type 1 diabetes patients in Belgium: A population based study

Technological advances in the management of Type 1 diabetes (T1D) are expected to have beneficial effects on the mortality. The aim was to investigate the excess mortality and the life expectancy (LE) of adult patients with T1D living and receiving treatment in Belgium compared with the general population.

Patients enrolled in the multidisciplinary care programme for the self-management of diabetes mellitus during the years 2017-2021 were included. Comorbidities were identified by proxies based on health and/or medication use.

In total 144960 patients/year (PY) were identified (2057 deaths). The standard mortality rate (95 % CI) was 1.21 (1.19;1.23), corresponding to an excess mortality rate of 3.2 deaths per 1000 PY. Renal insufficiency appeared to be the only comorbidity with a discernible effect on younger age groups. In T1D patients aged 20-50 years, LE results in a loss of 4 years of life.

Although our analysis showed a significantly lower excess mortality rate in T1D compared with older studies, a moderately increased excess risk of mortality is still shown. Given the continuous advances in diabetes treatment, it is important to perform further analyses to reassess the excess risk of mortality and to monitor this positive trend.