Diabetes Deaths Decline Overall, but Not Among the Young, in Study of More Than 1M

An Australian researcher, who previously documented a link between cancer and diabetes has found that while overall death rates from diabetes are falling, young people with the disease are not benefiting from this trend.

Jessica L. Harding, a research assistant at the Baker IDI Heart and Diabetes Institute in Melbourne, cross-referenced records of 1.189 million Australians in a national diabetes registry with the country’s National Death Index for the years 2000-2011.¹ Of the group, 7.3% had type 1 disease. Mortality rates in the total population were standardized to the 2001 Australian population.

The findings were published online Tuesday in Diabetes Care.

Researchers examined mortality rates for groups age 40 and under, those age 40 to 60, and those age 60 to age 85. They found that among those with type 1 (T1D) and type 2 diabetes (T2D), rates decreased for all-cause mortality, death from cardiovascular disease (CVD) and diabetes age-standardized mortality rates (meaning death related to diabetes). In fact, death rates decreased each year in all categories, although all-cause mortality rates fell faster. Cancer mortality among both groups remained unchanged.

However, Harding and her team found that those under age 40 did not see the same overall mortality benefit as the older population; also, they wrote, “the absence of a decline in cancer mortality warrants urgent attention.”

For those with T1D, all-cause mortality, CVD, and diabetes ASMR decreased each year by 0.61, 0.35, and 0.14 per 1000 per-years, respectively, between 2000 and 2011, according to the abstract. For T2D, all-cause mortality, CVD, and diabetes ASMR decreased each year by 0.18, 0.15, and 0.03 per 1000 person years, respectively.

Earlier work by Harding and fellow researchers explored unusually high rates of certain cancers among persons with diabetes, which the study team said could not be completely explained by research bias. The team has recommended that those with diabetes be screened for cancers associated with diabetes, which include those of the pancreas liver, and thyroid, and endometrium and ovary for women.²

References

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1. Harding JL, Shaw JE, Peeters A, Davidson S, Magliano DJ. Age-specific trends from 2000-2011 in all-cause and cause-specific mortality in type 1 and type 2 diabetes: a cohort study of more than 1 million people [published online April 26, 2016]. Diabetes Care. 2016; doi:10.2337/dc15-2308

2. Harding JL, Shaw JE, Peeters A, Cartensen B, Magliano DJ. Cancer risk among people with type 1 and type 2 diabetes: disentangling true associations, detection bias, and reverse causation. Diabetes Care. 2015;38(2):264-270. doi: 10.2337/dc14-1996.