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Mortality risk in people with Type 2 diabetes : a large prospective population-based cohort study (The Ayrshire Diabetes Follow-Up Cohort (ADOC) Study)

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Collier, A., Hairer, M., Cameron, L. , Ghosh, S., Boyle, J., Walters, M. and Waugh, Norman (2021) Mortality risk in people with Type 2 diabetes : a large prospective population-based cohort study (The Ayrshire Diabetes Follow-Up Cohort (ADOC) Study). Journal of Epidemiology and Public Health Reviews, 6 (1). doi:10.16966/2471-8211.209

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Official URL: http://dx.doi.org/10.16966/2471-8211.209

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Abstract

Background: This study investigated the effects of age, gender, socio-economic status, smoking status, hypertension, ischaemic heart disease, Body Mass Index (BMI), Glycaemic control (HbA1c) and dyslipidaemia in type 2 diabetes in a population-based analysis.

Methods: Data were collected from 46 General Practice databases in 2009 and 2014. Cox regressions were run in type 2 diabetes patients plus the non-diabetes population.

Results: Individuals with type 2 diabetes (n=16,643) had higher mortality rates than non-diabetes subjects. Ranked in order of Hazard Ratio (HR), increasing age (HR 2.31), smoking (HR 1.79), IHD (HR 1.65), deprivation (HR 1.36), hypertension (HR 1.23) and male gender (HR 1.20) all increased mortality risk (p<0.01). Statin therapy was associated with better outcome (HR 0.65, p<0.01). Abnormal lipid levels whilst not on a statin significantly increased mortality risk for raised total-cholesterol (HR 1.74) and low HDL-cholesterol (HR 1.48) but not for triglycerides (HR 0.67) (all p<0.01).

Conclusions: This large study confirmed that the all-cause mortality risk in type 2 diabetes remains elevated. We demonstrated that a man with type 2 diabetes of 5-10 years duration who smoked, had hypertension and IHD plus lived in the most deprived area had a HR of 6.2 compared with a non-smoking, normotensive, non-diabetes subject without IHD living in the least deprived area. Further research is required to understand the interaction between hypertension and type 2 diabetes plus why obesity and raised triglycerides appeared to be protective in type 2 diabetes.

Item Type: Journal Article
Subjects: Q Science > QP Physiology
R Medicine > RC Internal medicine
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Type 2 diabetes , Type 2 diabetes -- Mortality -- Scotland -- Ayrshire, Body mass index , Glycemic index , Cardiovascular system -- Diseases, Lipids -- Metabolism -- Disorders, Hypertension -- Diagnosis , Coronary heart disease -- Diagnosis
Journal or Publication Title: Journal of Epidemiology and Public Health Reviews
Publisher: Sci Forschen Inc
ISSN: 24718211
Official Date: 31 March 2021
Dates:
DateEvent
31 March 2021Published
24 February 2021Accepted
Volume: 6
Number: 1
DOI: 10.16966/2471-8211.209
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDAstraZenecahttp://dx.doi.org/10.13039/100004325

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