Related Experiment Videos
The association of glycemia and cause-specific mortality in a diabetic population
1Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison.
Insights
Improved blood glucose control in diabetics is linked to reduced mortality from vascular diseases and diabetes. This study highlights the importance of managing glycemia for better long-term outcomes in diabetic populations.
Area of Science:
- Endocrinology
- Epidemiology
- Cardiovascular Medicine
Background:
- Diabetes mellitus is a chronic condition associated with increased mortality risk.
- Glycemia, a measure of blood glucose levels, is a key factor in diabetes management.
- Understanding the association between glycemia and cause-specific mortality is crucial for public health.
Purpose of the Study:
- To investigate the association between glycemia and cause-specific mortality in a diabetic population.
- To differentiate these associations based on age of diabetes onset (younger vs. older).
Main Methods:
- A cohort study design was employed in a primary care setting.
- Participants included younger-onset (diagnosed <30 years, insulin-dependent) and older-onset diabetic individuals.
- Glycosylated hemoglobin levels were measured at baseline, with a median follow-up of 8.3-10 years to determine cause-specific mortality.
Main Results:
- In younger-onset diabetics, higher glycosylated hemoglobin was associated with increased mortality from diabetes and ischemic heart disease.
- In older-onset diabetics, higher glycosylated hemoglobin was linked to increased mortality from diabetes, ischemic heart disease, and stroke.
- No significant association was found between glycosylated hemoglobin and cancer mortality in the older-onset group.
Conclusions:
- These findings suggest that better glycemic control may reduce the risk of death from vascular diseases and diabetes.
- The results underscore the importance of managing blood glucose levels in diabetic patients to mitigate mortality risks.
Background:
The purpose of this study was to investigate the association of glycemia with cause-specific mortality in a diabetic population.
Methods:
The study was a cohort design based in a primary care setting. Participants were all younger-onset diabetic persons (conditions diagnosed when they were younger than 30 years old and taking insulin, N = 1210) and a random sample of older-onset diabetic persons (conditions diagnosed when they were 30 years or older, N = 1780). Glycosylated hemoglobin levels were obtained at baseline examinations in 1980 to 1982 in which 996 younger-onset and 1370 older-onset persons participated. Median follow-up was 10 years in younger-onset and 8.3 years in older-onset persons; four younger-onset and two older-onset persons were unavailable for follow-up. The main outcome measure was cause-specific mortality as determined from death certificates.
Results:
In the younger-onset group after controlling for other risk factors in proportional hazards models and considering underlying cause of death, glycosylated hemoglobin was significantly associated with mortality from diabetes (hazard ratio [HR] for a 1% change in glycosylated hemoglobin, 1.25; 95% confidence interval [CI], 1.13 to 1.38) and ischemic heart disease (HR, 1.18; 95% CI, 1.00 to 1.40). In the older-onset group, glycosylated hemoglobin was significantly associated with mortality from diabetes (HR, 1.32; 95% CI, 1.21 to 1.43), ischemic heart disease (HR, 1.10; 95% CI, 1.04 to 1.17), and stroke (HR, 1.17; 95% CI, 1.05 to 1.30), but not cancer (HR, 0.99; 95% CI, 0.88 to 1.10). Results for any mention of specific causes of death were similar.
Conclusion:
These results suggest possible benefit to the control of glycemia with respect to death due to vascular disease and diabetes.