The British Diabetic Association Cohort Study, I: all-cause mortality in patients with insulin-treated diabetes mellitus

Aims To assess mortality in patients with diabetes incident under the age o f 30 years. Methods A cohort of 23752 diabetic patients diagnosed under the age of 30 y ears from throughout the United Kingdom was identified during 1972-93 and f ollowed up to February 1997, Following notification of deaths during this p eriod, age- and sex-specific mortality rates, attributable risks and standa rdized mortality rates were calculated. Results The 23752 patients contributed a total of 317522 person-years of fo llow-up, an average of 13.4) ears per subject. During follow-up 949 deaths occurred in patients between the ages of 1 and 84 years, 566 in males and 3 83 in females. All-cause mortality rates in the patients with diabetes exce eded chose in the general population at all ages and within the cohort were higher fur males than females at all ages except between 5 and 15 years. T he relative risk of death (standardized mortality ratio, SMR), was higher f or females than males at all ages, being 4.0 (95% CI 3.6-4.4) for females a nd 2.7 (2.5-2.9) for males overall, bur reaching a peak of 5.7 (4.7-7.0) in females aged 20-29, and of 4.0 (3.1-5.0) in males aged 40-49. Attributable risks, or the excess deaths in persons with diabetes compared with the gen eral population, increased with age in both sexes. Conclusions This is the first study from the UF; of young patients diagnose d with diabetes that is large enough to calculate detailed age-specific mor tality rates, This study provides a baseline for further studies of mortali ty and change in mortality within the United Kingdom.