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  • 1
    ISSN: 1432-0428
    Keywords: Mortality ; Type 1 (insulin-dependent) diabetes ; Type 2 (non-insulin-dependent) diabetes ; standardised mortality ratio ; myocardial infarction ; ischaemic heart disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The 497 members of the London Cohort of the WHO Multinational Study of Vascular Disease in Diabetics have been followed for mortality from 1975 to 1987. During this period 92 patients died. The most common cause of death was myocardial infarction: 36 (39.1%) deaths, heart disease was responsible for 51.1% of deaths and all cardiovascular disease for 55.4%. Neoplastic disease accounted for 25% of the deaths and diabetic nephropathy for 5.4%. Age-standardised mortality rates were higher in men than in women in both Type 1 (insulin-dependent) diabetes and Type 2 (non-insulin-dependent) diabetes. Standardised mortality ratios for the first and second five year follow-up periods were higher for men than for women in Type 2 diabetes but were higher for women than men in Type 1. The results suggest that the female survival advantage seen in the general population may persist in Type 2 but not in Type 1 diabetes.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Mortality ; insulin-dependent diabetes ; non-insulin-dependent diabetes ; circulatory disease ; epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Mortality among 4740 diabetic men and women aged 35–55 years participating in the WHO Multinational Study of Vascular Disease in Diabetics has been studied. Ten of the original centres (Warsaw, Berlin, Havana, Arizona, Oklahoma, Hong Kong, Switzerland, London, Tokyo, Zagreb) were able to identify the life/death status of their study participants on 1 January 1983, giving an average follow-up period of six to seven years. All-cause mortality rates in males varied about threefold among the ten participating centres with the highest rates in Warsaw, Berlin and Havana and the lowest rates in Tokyo and Zagreb. All-cause mortality rates for females varied about fourfold with the highest rates in Warsaw and Oklahoma and the lowest rates in Tokyo. The proportion of deaths ascribed to circulatory disease varied among the centres ranging from 32% for males and 0% for females in Tokyo to 67% for males and 47% for females in London. There was an excess all-cause mortality in males compared to females for all centres except Zagreb. This excess also applied to circulatory diseases in general, ischaemic heart disease in particular and occurred in both insulin-dependent and non-insulin-dependent diabetic patients. Death rates for insulin-dependent diabetic patients were generally higher than those for non-insulin-dependent patients.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Mortality ; Type 1 (insulin-dependent) diabetes ; Type 2 (non-insulin-dependent) diabetes ; risk factors ; hypertension ; proteinuria
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Potential risk factors have been examined for association with mortality over a 10–12 year follow-up of the patients of the London Cohort of the WHO Multinational Study of Vascular Disease in Diabetics (aged 35–54 year in at entry to the study). Proteinuria has the strongest association with all-cause mortality in univariate analysis being significant in patients of both sexes with Type 2 (non-insulin-dependent) diabetes mellitus and in women with Type 1 (insulin-dependent) diabetes mellitus; both systolic blood pressure (men) and hypertension (both sexes) (as a categorical variable) are significant in Type 1 diabetes. Hypertension is also significantly associated with all-cause mortality in multivariate analysis in both sexes with Type 1 diabetes as proteinuria is in women with Type 2 diabetes. There is an unexpected negative association between plasma creatinine and all-cause mortality in men with Type 2 diabetes. Systolic blood pressure and hypertension are also significantly linked with cardiovascular mortality in Type 1 diabetes, hypertension having an estimated relative risk of 18.6 in multivariate analysis. Serum cholesterol and proteinuria showed the strongest associations with cardiovascular mortality in Type 2 diabetes. Proteinuria is associated with non-cardiovascular mortality in both types of diabetes in univariate but not multivariate analysis. In multivariate analysis hypertension (Type 1 diabetes) and diabetes duration (Type 2 diabetes) are associated with non-cardiovascular mortality. Hypertension and proteinuria have the most consistent associations with mortality in the different analyses with the effect of hypertension appearing stronger in Type 1 diabetes and proteinuria in Type 2 diabetes. Some other proven risk factors in non-diabetic populations had inconstant or absent associations in this group: other, as yet undefined, factors may be important in diabetes.
    Type of Medium: Electronic Resource
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