Complications during Adolescence Predict Mortality in Young Adults with Childhood Onset Type 1 Diabetes
Authors' conclusion
Mortality in young adults with type 1 diabetes is predicted by subclinical markers of autonomic neuropathy and elevated AER during adolescence, but not glycemia. Mortality was over twice that of the background population in females but not in males.
Study context
- Population
- Adolescents with childhood-onset T1D diagnosed 1973–1993, 48% male, median age at final complications assessment 17.4 years (IQR 16.0–18.9), followed median 22.3 years (21.0–23.4) from diagnosis
- Participants
- 409 adolescents
- Exposure
- Adolescent microvascular complications and mortality
- Outcome
- Mortality
- Follow-up
- Data linkage 8-13 years after final adolescent visit
Methodological detailslongitudinal, data linkage with the Australian National Death Index
- Longitudinal
- Data linkage with the Australian National Death Index
Main finding
As reported in the abstract
Predictors of mortality (multivariable generalized estimating equations (GEE))
- Deceased
- 14 (3% of cohort)
- Elevated albumin excretion rate (AER), OR
- 4.54, 1.23-16.80, p=0.030
- Pupillary abnormality, OR
- 4.27, 1.20-15.22, p=0.023
- Systolic blood pressure SDS, OR
- 2.17, 1.26-3.74, p=0.005
- CAN, OR
- 4.65, 1.03-21.0, p=0.045
Observational data: associations, not effects.
Further findings
Standardized mortality ratio (SMR)
- Overall SMR
- 2.5 (1.4-4.2)
- SMR in females
- 3.5, 1.3-7.8
- SMR in males
- 2.1, 0.9-4.0
Complications at final adolescent visit
- CAN abnormality
- 20%
- Abnormal pupillary response
- 30%
- Albuminuria
- 20%
- Early elevation of AER
- 40%
- Retinopathy
- 45%
Causes of death
- Deaths due to acute or chronic diabetes complications
- 25%
Original publication
Complications during Adolescence Predict Mortality in Young Adults with Childhood Onset Type 1 Diabetes. Pediatr Diabetes. Published 12 April 2024. doi:10.
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