All-Cause Mortality in Patients with Childhood Onset Diabetes Mellitus
Author: Savova, Radka Н.1, Archinkova, Margarita A.1, Kundurzhiev, Todor G.2Slavcheva, Olga T.1, Yaneva, Natasha Y.1, Modeva, Iskra V. 1, Konstantinova, Maia M.1
2. Faculty of Public Health, Medical University, Sofia
Abstract:
Aim: To establish all cause mortality in patients with childhood onset diabetes mellitus.
Material and methods: A representative sample of 670 patients, consisting of at least 1 patient from every age interval 0-17 at the time of diagnosis and each calendar year 1975 to 2014 was submitted to the National Agency for Personal Identification. The correct personal data for 614 patients (surviving or deceased) were included in a comparative analysis according to age (0-4, 5-9, 10-17), gender, calendar year of diagnosis ( <1995>), duration of diabetes ( ≤5, 6-9, 10-14, 15-19, > 19 years), education and the place of residence of the family.
Results: The number of deceased patients was 56 (36 males) with no gender related difference, X2=3,56, p=0,059). The mean age of death was 28,8 ±7,5 years (5,6-43,2 years) and the mean disease duration was 20,3±8,1 years (7 months – 38 years). All-cause cumulative mortality was 9,11%. The disease duration was a risk factor for death (X2=17,71, p=0,005) as well as the calendar year at diagnosis <1995> (X2=34,73, p<0,001). Adjusted for disease duration, diagnosis before 1995 was an independent risk factor for death (OR=0,006, p<0,001). A higher risk of mortality was found among boys aged ≥10 years at diagnosis and in patients from families with a low standard or education. The mean survival age was 37,5 years (95% CI 36,4-38,6) and was unrelated to the calendar year at diagnosis (Log rank test (Mantel-Cox) – р=0,290). The survival of patients diagnosed at age ≥10 years was 33,5 years (95% CI 31,5; 35,4), significantly lower compared to those aged 5-9 years – 34,1 years (95% CI 32,8; 35,3) and those aged <5 years – 39,6 years (95% CI 38,3; 40,9), p<0,001.
Conclusion: The cumulative mortality among patients with childhood onset diabetes is high. Puberty, male gender as well as a low standard of education of the parents have a negative influence on the prognosis of the disease.
Savova
Key words: diabetes mellitus, mortality, survival, risk factors
