All-cause mortality and risk factors in patients with type 1 diabetes in Castilla-La Mancha, Spain. DIACAM1 2010-2020 study

Prim Care Diabetes. 2024 Feb;18(1):59-64. doi: 10.1016/j.pcd.2023.11.003. Epub 2023 Nov 15.

Abstract

Introduction: Despite better treatments and care for patients with type 1 diabetes (T1DM), all-cause and cardiovascular mortality still remains higher compared to the general population. We evaluated mortality and risk factors for mortality in a representative cohort of patients with T1DM.

Methods: DIACAM1 was a cross-sectional, multicenter study on adult patients (≥ 16 years old) and diabetes with at least 5 years since diabetes diagnosis conducted between 2009 and 2010. DIACAM1 2010-2020 study was a follow-up study, extension of DIACAM1, where vital status of patients was evaluated between June 2019 and June 2020.

Results: 4.03% [CI95%, 2.53-5.62) of the 1465 patients with T1DM included in the cohort of the DIACAM1 in 2010 had died. Survival was lower than in the sex- and age-matched general population in the same region. 40.7% of deaths were due to cardiovascular disease. HbA1c levels < 7% and triglyceride levels < 150 mg/dL were associated with lower mortality, whereas retinopathy and plasma creatinine were associated with increased mortality.

Conclusions: We confirmed a lower survival in people with T1DM, with cardiovascular disease being the main cause of mortality. High HbA1c, high triglycerides, retinopathy, and high creatinine are factors associated with mortality.

Keywords: Diabetes mellitus; Mortality; Risk factors; Survival; Type 1.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / epidemiology
  • Creatinine
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1* / diagnosis
  • Diabetes Mellitus, Type 1* / drug therapy
  • Follow-Up Studies
  • Glycated Hemoglobin
  • Humans
  • Retinal Diseases* / complications
  • Risk Factors
  • Spain / epidemiology

Substances

  • Glycated Hemoglobin
  • Creatinine