True or false: Between 1999-2004 and 2005-2010, cancer replaced CV/CHD as leading cause of death in T2D.
Complications from type 2 diabetes (T2D) have been declining for the last 20 years. Research suggests people are adhering to medication and managing their risk factors better.1 Public health efforts and advances in medical technology and pharmacology translated into decreased deaths from CHD between 1980-2000.2What impact has this had on mortality in T2D?A recent study published in Diabetes, Obesity, and Metabolism used NHANES data to compare mortality rates and causes of death among people with T2D over time. Top-line results are offered in the slides above.Â
1. Ali MK, Bullard KM, Saaddine JB, et al. Achievement of goals in U.S. diabetes care, 1999-2010.N Engl J Med. 2013 Apr 25;368:1613-24. doi: 10.1056/NEJMsa1213829
2. Ford ES, Ajani UA, Croft JB, et al. Explaining the decrease in U.S. deaths from coronary disease, 1980-2000.N Engl J Med. 2007; 356: 2388-2398
3. Tsujimoto T, Kajio H, Sugiyama T,et al. Favourable changes in mortality in people with diabetes - U.S. NHANES 1999-2010.Diabetes Obes Metab. 2017 Jun 22. doi: 10.1111/dom.13039.
Prospective cohort study
looked at mortality among people with T2D between 1999 and 2010, comparing 2 5-year periods.
Mortality from CVD and CHD saw greater declines,
showing a 59% and 70% drop, respectively, between 1999-2004 vs 2005-2010.
It's possible that more people with milder disease have been diagnosed, so overall risk of CVD death is lower; sensitivity analyses were limited to recently diagnosed T2D showed lower CV, CHD mortality.
Improvements in mortality for T2D may reflect improvements in healthcare, diagnosis, treatment of comorbidities, declines in smoking rates.