Mortality From Cerebrovascular Disease in a Cohort of 23 000 Patients With Insulin-Treated Diabetes
S. P. LaingFrom the Institute of Cancer Research (S.P.L., A.J.S., Z.Q.), London; Oxford University (L.M.C.), Oxford; the Strathclyde Diabetic Group (S.D.S.), Glasgow; the University of Leicester (A.C.B., J.L.B.), Leicester; the Royal College of Physicians of Edinburgh (A.D.M.), Edinburgh; the Scottish Study Group for the Care of Diabetes in the Young (N.R.W.), Aberdeen; the Poole Hospital NHS Trust (W.G.), Poole; the University of Bristol (E.A.M.G.), Bristol; The Queen’s University (C.C.P.), Belfast; and Guy’sAnthony J. SwerdlowFrom the Institute of Cancer Research (S.P.L., A.J.S., Z.Q.), London; Oxford University (L.M.C.), Oxford; the Strathclyde Diabetic Group (S.D.S.), Glasgow; the University of Leicester (A.C.B., J.L.B.), Leicester; the Royal College of Physicians of Edinburgh (A.D.M.), Edinburgh; the Scottish Study Group for the Care of Diabetes in the Young (N.R.W.), Aberdeen; the Poole Hospital NHS Trust (W.G.), Poole; the University of Bristol (E.A.M.G.), Bristol; The Queen’s University (C.C.P.), Belfast; and Guy’sLucy CarpenterFrom the Institute of Cancer Research (S.P.L., A.J.S., Z.Q.), London; Oxford University (L.M.C.), Oxford; the Strathclyde Diabetic Group (S.D.S.), Glasgow; the University of Leicester (A.C.B., J.L.B.), Leicester; the Royal College of Physicians of Edinburgh (A.D.M.), Edinburgh; the Scottish Study Group for the Care of Diabetes in the Young (N.R.W.), Aberdeen; the Poole Hospital NHS Trust (W.G.), Poole; the University of Bristol (E.A.M.G.), Bristol; The Queen’s University (C.C.P.), Belfast; and Guy’sS. D. SlaterFrom the Institute of Cancer Research (S.P.L., A.J.S., Z.Q.), London; Oxford University (L.M.C.), Oxford; the Strathclyde Diabetic Group (S.D.S.), Glasgow; the University of Leicester (A.C.B., J.L.B.), Leicester; the Royal College of Physicians of Edinburgh (A.D.M.), Edinburgh; the Scottish Study Group for the Care of Diabetes in the Young (N.R.W.), Aberdeen; the Poole Hospital NHS Trust (W.G.), Poole; the University of Bristol (E.A.M.G.), Bristol; The Queen’s University (C.C.P.), Belfast; and Guy’sA C BurdenFrom the Institute of Cancer Research (S.P.L., A.J.S., Z.Q.), London; Oxford University (L.M.C.), Oxford; the Strathclyde Diabetic Group (S.D.S.), Glasgow; the University of Leicester (A.C.B., J.L.B.), Leicester; the Royal College of Physicians of Edinburgh (A.D.M.), Edinburgh; the Scottish Study Group for the Care of Diabetes in the Young (N.R.W.), Aberdeen; the Poole Hospital NHS Trust (W.G.), Poole; the University of Bristol (E.A.M.G.), Bristol; The Queen’s University (C.C.P.), Belfast; and Guy’sJohannes L. BothaFrom the Institute of Cancer Research (S.P.L., A.J.S., Z.Q.), London; Oxford University (L.M.C.), Oxford; the Strathclyde Diabetic Group (S.D.S.), Glasgow; the University of Leicester (A.C.B., J.L.B.), Leicester; the Royal College of Physicians of Edinburgh (A.D.M.), Edinburgh; the Scottish Study Group for the Care of Diabetes in the Young (N.R.W.), Aberdeen; the Poole Hospital NHS Trust (W.G.), Poole; the University of Bristol (E.A.M.G.), Bristol; The Queen’s University (C.C.P.), Belfast; and Guy’sAndrew D. MorrisFrom the Institute of Cancer Research (S.P.L., A.J.S., Z.Q.), London; Oxford University (L.M.C.), Oxford; the Strathclyde Diabetic Group (S.D.S.), Glasgow; the University of Leicester (A.C.B., J.L.B.), Leicester; the Royal College of Physicians of Edinburgh (A.D.M.), Edinburgh; the Scottish Study Group for the Care of Diabetes in the Young (N.R.W.), Aberdeen; the Poole Hospital NHS Trust (W.G.), Poole; the University of Bristol (E.A.M.G.), Bristol; The Queen’s University (C.C.P.), Belfast; and Guy’sNorman WaughFrom the Institute of Cancer Research (S.P.L., A.J.S., Z.Q.), London; Oxford University (L.M.C.), Oxford; the Strathclyde Diabetic Group (S.D.S.), Glasgow; the University of Leicester (A.C.B., J.L.B.), Leicester; the Royal College of Physicians of Edinburgh (A.D.M.), Edinburgh; the Scottish Study Group for the Care of Diabetes in the Young (N.R.W.), Aberdeen; the Poole Hospital NHS Trust (W.G.), Poole; the University of Bristol (E.A.M.G.), Bristol; The Queen’s University (C.C.P.), Belfast; and Guy’sW. GatlingFrom the Institute of Cancer Research (S.P.L., A.J.S., Z.Q.), London; Oxford University (L.M.C.), Oxford; the Strathclyde Diabetic Group (S.D.S.), Glasgow; the University of Leicester (A.C.B., J.L.B.), Leicester; the Royal College of Physicians of Edinburgh (A.D.M.), Edinburgh; the Scottish Study Group for the Care of Diabetes in the Young (N.R.W.), Aberdeen; the Poole Hospital NHS Trust (W.G.), Poole; the University of Bristol (E.A.M.G.), Bristol; The Queen’s University (C.C.P.), Belfast; and Guy’sEdwin GaleFrom the Institute of Cancer Research (S.P.L., A.J.S., Z.Q.), London; Oxford University (L.M.C.), Oxford; the Strathclyde Diabetic Group (S.D.S.), Glasgow; the University of Leicester (A.C.B., J.L.B.), Leicester; the Royal College of Physicians of Edinburgh (A.D.M.), Edinburgh; the Scottish Study Group for the Care of Diabetes in the Young (N.R.W.), Aberdeen; the Poole Hospital NHS Trust (W.G.), Poole; the University of Bristol (E.A.M.G.), Bristol; The Queen’s University (C.C.P.), Belfast; and Guy’sChristopher PattersonFrom the Institute of Cancer Research (S.P.L., A.J.S., Z.Q.), London; Oxford University (L.M.C.), Oxford; the Strathclyde Diabetic Group (S.D.S.), Glasgow; the University of Leicester (A.C.B., J.L.B.), Leicester; the Royal College of Physicians of Edinburgh (A.D.M.), Edinburgh; the Scottish Study Group for the Care of Diabetes in the Young (N.R.W.), Aberdeen; the Poole Hospital NHS Trust (W.G.), Poole; the University of Bristol (E.A.M.G.), Bristol; The Queen’s University (C.C.P.), Belfast; and Guy’sZongkai QiaoThe Queen's University (C.C.P.), BelfastH. KeenFrom the Institute of Cancer Research (S.P.L., A.J.S., Z.Q.), London; Oxford University (L.M.C.), Oxford; the Strathclyde Diabetic Group (S.D.S.), Glasgow; the University of Leicester (A.C.B., J.L.B.), Leicester; the Royal College of Physicians of Edinburgh (A.D.M.), Edinburgh; the Scottish Study Group for the Care of Diabetes in the Young (N.R.W.), Aberdeen; the Poole Hospital NHS Trust (W.G.), Poole; the University of Bristol (E.A.M.G.), Bristol; The Queen’s University (C.C.P.), Belfast; and Guy’s
2003en
ABI
Annotatsiya
BACKGROUND AND PURPOSE: Disease of the cardiovascular system is the main cause of long-term complications and mortality in patients with type I (insulin-dependent) and type II (non-insulin-dependent) diabetes. Cerebrovascular mortality rates have been shown to be raised in patients with type II diabetes but have not previously been reported by age and sex in patients with type I diabetes. METHODS: A cohort of 23 751 patients with insulin-treated diabetes, diagnosed under the age of 30 years from throughout the United Kingdom, was identified during 1972 to 1993 and followed up for mortality until the end of December 2000. Age- and sex-specific mortality rates and standardized mortality ratios (SMRs) were calculated. RESULTS: There were 1437 deaths during the follow-up, 80 due to cerebrovascular disease. Overall, the cerebrovascular mortality rates in the cohort were higher than the corresponding rates in the general population, and the SMRs were 3.1 (95% CI, 2.2 to 4.3) for men and 4.4 (95% CI, 3.1 to 6.0) for women. When stratified by age, the SMRs were highest in the 20- to 39-year age group. After subdivision of cause of death into hemorrhagic and nonhemorrhagic origins, there remained a significant increase in mortality from stroke of nonhemorrhagic origin. CONCLUSIONS: Analyses of mortality from this cohort, essentially one of patients with type I diabetes, has shown for the first time that cerebrovascular mortality is raised at all ages in these patients. Type I diabetes is at least as great a risk factor for cerebrovascular mortality as type II diabetes.
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