Dawson Shelagh I, Willis Jinny, Florkowski Christopher M, Scott Russell S
Centre for Postgraduate Nursing, Christchurch School of Medicine, University of Otago, New Zealand.
Diabetes Res Clin Pract. 2008 Apr;80(1):16-23. doi: 10.1016/j.diabres.2007.10.034. Epub 2008 Mar 7.
Diabetes is one of the most common chronic diseases in Western populations. There have been few large published cohort studies of diabetes with 20 years of follow-up worldwide, and none other than the present one in NZ.
To establish cause-specific death rates, by age and sex in insulin-treated diabetic individuals living in Canterbury, NZ.
Insulin-treated diabetic subjects on the Canterbury Diabetes Registry were followed over 20 years and vital status determined. Following notification of deaths, age- and sex-specific mortality rates, and sex-specific mortality ratios (SMRs) were calculated.
During follow-up 966 diabetic subjects contributed 13,495 person-years and 525 deaths occurred (261 females and 264 males). At all ages mortality rates were considerably higher than expected mortality. Relative mortalities were increased for cardiovascular (SMR women 3.73, 95% CI: 3.16-4.30; men 3.27, 95% CI: 2.76-3.78), renal (SMR women 5.55, 95% CI: 2.53-8.57; men 7.15, 95% CI: 3.40-10.90), respiratory disease (SMR women 3.31, 95% CI: 1.98-4.63; men 2.32, 95% CI: 1.41-3.23) and malignancy (SMR women 4.99, 95% CI: 2.99-6.99; men 2.19, 95% CI: 1.42-2.96) with cardiovascular disease accounting for the single greatest cause of excess death at all ages.
Mortality rates for diabetic individuals remain high, resulting in shortened life spans relative to the general population. To reduce these death rates attention must be paid to the early detection and treatment of CVD and associated risk factors.
糖尿病是西方人群中最常见的慢性病之一。全球范围内很少有已发表的对糖尿病进行20年随访的大型队列研究，新西兰除了本研究外没有其他此类研究。
确定新西兰坎特伯雷地区接受胰岛素治疗的糖尿病患者按年龄和性别的特定病因死亡率。
对坎特伯雷糖尿病登记处中接受胰岛素治疗的糖尿病患者进行了20年的随访，并确定了其生命状态。在死亡通知后，计算了按年龄和性别划分的死亡率以及按性别划分的死亡率比（SMR）。
在随访期间，966名糖尿病患者贡献了13495人年，发生了525例死亡（女性261例，男性264例）。在所有年龄段，死亡率均大大高于预期死亡率。心血管疾病（女性SMR 3.73，95%置信区间：3.16 - 4.30；男性3.27，95%置信区间：2.76 - 3.78）、肾脏疾病（女性SMR 5.55，95%置信区间：2.53 - 8.57；男性7.15，95%置信区间：3.40 - 10.90）、呼吸系统疾病（女性SMR 3.31，95%置信区间：1.98 - 4.63；男性2.32，95%置信区间：1.41 - 3.23）和恶性肿瘤（女性SMR 4.99，95%置信区间：2.99 - 6.99；男性2.19，95%置信区间：1.42 - 2.96）的相对死亡率均有所增加，其中心血管疾病是各年龄段超额死亡的单一最大原因。
糖尿病患者的死亡率仍然很高，与普通人群相比寿命缩短。为降低这些死亡率，必须重视心血管疾病及相关危险因素的早期检测和治疗。
