NEW YORK (Reuters Health) - Relative to their peers without type 1 diabetes, patients who are diagnosed with the disease in young adulthood are at greater risk for death than those diagnosed in childhood, according to a report in the journal Diabetes Care.
Dr. Richard G. Feltbower, of the University of Leeds, UK, and colleagues examined death rates and causes of death among patients with type 1 diabetes entered in a database in Yorkshire, UK, between 1978 and 2004. The subjects, who were all under 30 years of age, were then linked with the UK National Health Service Central Register for death notifications.
A total of 4246 patients were included in the study. Of these patients, 3349 were diagnosed between the ages of 0 and 14 years and 897 were diagnosed between the ages of 15 and 29 years. The younger group was followed for an average of 12.8 years, and the older group was followed for an average of 8.3 years.
During the course of the study,108 patients died, including 74 in the younger group and 34 in the older group.
Overall, the diabetics in the study were 4.7-times more likely to die during follow-up than similar-aged individuals drawn from the general population.
The relative death risk, however, differed for younger and older diabetic patients. In individuals between 15 and 29 years of age, diabetes increased the risk of death by 6.2-fold, whereas in younger people, the disease raised the risk by 4.2-fold.
The risk of death increased with increasing disease duration, the report indicates.
Of the 108 deaths, 47 resulted from diabetes complications. Twenty-four deaths were related to accidents or violence, including six suicides.
In addition, 17 deaths were attributed to drug abuse, which included insulin overdoses, as well as overdoses with other drugs, mainly with opiates.
"These are important new findings for (doctors) treating young people with type 1 diabetes, as we have identified a propensity for young-adult subjects to misuse drugs or take insulin overdoses," Feltbower's team concludes.
SOURCE: Diabetes Care, May 2008.