Diabetes Q&A

In Diabetes, Age of Diagnosis Affects Mortality Risk

The age at which an individual is diagnosed with type 2 diabetes affects the risk of cardiovascular disease (CVD) and mortality, according to the results of a recent study.

While it appears that age of diagnosis affects CVD and mortality risk with type 2 diabetes, few population studies have analyzed outcomes across the full age range, according to the study authors.

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Using data from the Swedish National Diabetes Registry, the researchers sought to explore this relationship further.

They matched 3,19,083 patients with type 2 diabetes with approximately 1.6 million controls taken randomly from the general population. Outcomes included total mortality, cardiovascular-related mortality, noncardiovascular mortality, coronary heart disease, acute myocardial infarction, stroke, heart failure, and atrial fibrillation.

Overall, those individuals diagnosed with type 2 diabetes at or before age 40 years had the highest excess risk for outcomes compared with controls. Adjusted hazard ratios (HRs) were 2.05 for total mortality, 2.72 for cardiovascular-related mortality, 1.95 for noncardiovascular mortality, 4.77 for heart failure, and 4.33 for coronary heart disease.

“All risks attenuated progressively with each increasing decade at diagnostic age,” the researchers noted.  Those diagnosed beyond age 80 years had similar survival as that of matched controls.

“Age at diagnosis of type 2 diabetes mellitus is prognostically important for survival and cardiovascular risks, with implications for determining the timing and intensity of risk factor interventions for clinical decision making and for guideline-directed care,” the researchers concluded.

—Michael Potts

Reference:

Sattar N, Rawshani A, Franzen S, et al. Age at diagnosis of type 2 diabetes mellitus and associations with cardiovascular and mortality risks. Circulation. doi: 10.1161/CIRCULATIONAHA.118.037885.