Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department and Graduate Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Diabetes Res Clin Pract. 2015 Jan;107(1):178-86. doi: 10.1016/j.diabres.2014.09.021. Epub 2014 Oct 5.
This study aims to investigate the distribution of underlying-causes-of-death (UCOD) among deceased patients with type 2 diabetes mellitus (DM) in Taiwan and assess the influence of socio-demographic characteristics on mortality in type 2 DM patients.
A cohort study on patients who sought medical care for type 2 DM from 2000 to 2008 was conducted on 65,599 type 2 DM patients retrieved from the 1-million beneficiaries randomly selected from Taiwan's National Health Insurance Database. The study cohort was then linked to Taiwan's Mortality Registry to ascertain the patients who died between 2000 and 2009. We examined the distribution of UCOD in the deceased subjects. The hazard ratios of mortality in relation to socio-demographic characteristics were estimated from Cox proportional hazard model.
The leading causes of death in type 2 DM included neoplasm (22.68%), cardiovascular diseases (21.46%), and endocrine diseases (20.78%). Male gender and older ages were associated with significantly increased risk of mortality. In addition, lower urbanization and greater co-morbidity score were also significantly associated with an increased risk of mortality with a dose-gradient pattern.
Neoplasm accounts for the largest portion (22.68%) of deaths in type 2 DM patients closely followed by with cardiovascular diseases (21.46%). An increased risk of mortality in type 2 DM patients in lower urbanized areas may reflect poor diabetes care in these areas.
本研究旨在调查台湾地区 2 型糖尿病（DM）死亡患者的根本死因（UCOD）分布，并评估社会人口特征对 2 型 DM 患者死亡率的影响。
对 2000 年至 2008 年因 2 型 DM 就诊的患者进行了一项队列研究，从台湾全民健康保险数据库中随机抽取的 100 万受益人群中选取了 65599 例 2 型 DM 患者。然后，将研究队列与台湾死亡率登记处进行关联，以确定 2000 年至 2009 年期间死亡的患者。我们检查了死亡患者中 UCOD 的分布。使用 Cox 比例风险模型估计与社会人口特征相关的死亡率的风险比。
2 型 DM 的主要死亡原因包括肿瘤（22.68%）、心血管疾病（21.46%）和内分泌疾病（20.78%）。男性性别和年龄较大与死亡率显著增加相关。此外，城市化程度较低和共病评分较高也与死亡率增加显著相关，呈剂量梯度模式。
肿瘤占 2 型 DM 患者死亡的最大部分（22.68%），其次是心血管疾病（21.46%）。城市化程度较低的 2 型 DM 患者死亡率增加可能反映了这些地区较差的糖尿病护理。
