All‐cause and cardiorenal mortality in 6 million adults with and without type 2 diabetes: A comparative, trend analysis in Canada, Spain, and the UK
Authors' conclusion
By reducing the confounding impact of epidemiological and analytical differences, this study showed geographical similarities and differences in the diabetes gap: an excess risk of all-cause and cardiorenal mortality in subjects with T2D is still present in Ontario and England in recent years, particularly in elderly subjects. Conversely, there were very small gaps in young men with T2D or even lower mortality rates in older subjects with T2D in Catalonia.
Study context
- Population
- Subjects aged over 35 years in Canada (Ontario), Spain (Catalonia) and the UK (England)694,454 deaths
- Participants
- 6 million subjects
- Exposure
- Incident T2D vs no diabetes
- Outcome
- Diabetes gap: excess all-cause mortality associated with T2D (rate ratios and rate differences)
Methodological detailsmultinational, harmonized design and analytical strategy, matched to up to five subjects without diabetes, Poisson models, Follow-up of 52 million person-years
- Multinational
- Harmonized design and analytical strategy
- Matched to up to five subjects without diabetes
- Poisson models
- Follow-up of 52 million person-years
Main finding
As reported in the abstract
All-cause mortality diabetes gap (excess mortality with T2D), by country, age and sex · 2018
T2D vs No diabetesRate ratio (CI)
Catalonia, men, 50 years old
1.53(1.11–2.11)
Catalonia, men, 60 years old
0.88(0.72–1.06)
Catalonia, men, 70 years old
0.74(0.60–0.90)
Catalonia, men, 80 years old
0.81(0.66–1.00)
- More deaths per 1000 person-years in 50-year-old men with diabetes, Ontario
- 1.3 (0.8, 1.8) (95% CI)
- More deaths per 1000 person-years in 50-year-old men with diabetes, England
- 0.8 (0.2, 1.5) (95% CI)
- More deaths per 1000 person-years in 80-year-old men with diabetes, Ontario
- 8.9 (6.1, 11.7)
- More deaths per 1000 person-years in 80-year-old men with diabetes, England
- 12.1 (9.1, 15.1)
Observational data: associations, not effects.
Further findings
- Diabetes gaps in cardiorenal mortality mirrored those of all-cause mortality; consistent reductions in proportions of cardiorenal deaths at age 80 but variations at ≤70 years, regardless of diabetes
Original publication
All‐cause and cardiorenal mortality in 6 million adults with and without type 2 diabetes: A comparative, trend analysis in Canada, Spain, and the UK. Diabetes Obes Metab. Published 26 September 2022. doi:10.
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