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Increased Mortality Risk in People with Type 2 Diabetes Mellitus in Lithuania

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  • Donata Linkeviciute-Ulinskiene

    (Institute of Biomedical Sciences, Department of Pathology, Forensic Medicine and Pharmacology, Faculty of Medicine, Vilnius University, Ciurlionio g. 21, 03101 Vilnius, Lithuania)

  • Auguste Kaceniene

    (Laboratory of Cancer Epidemiology, National Cancer Institute, P. Baublio g. 3b, 08406 Vilnius, Lithuania)

  • Audrius Dulskas

    (Laboratory of Cancer Epidemiology, National Cancer Institute, P. Baublio g. 3b, 08406 Vilnius, Lithuania
    Department of Abdominal and General Surgery and Oncology, National Cancer Institute, Santariskiu g. 1, 08406 Vilnius, Lithuania)

  • Ausvydas Patasius

    (Laboratory of Cancer Epidemiology, National Cancer Institute, P. Baublio g. 3b, 08406 Vilnius, Lithuania
    Institute of Health Sciences, Faculty of Medicine, Vilnius University, Ciurlionio g. 21, 03101 Vilnius, Lithuania)

  • Lina Zabuliene

    (Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu g. 2, 08406 Vilnius, Lithuania)

  • Giedre Smailyte

    (Laboratory of Cancer Epidemiology, National Cancer Institute, P. Baublio g. 3b, 08406 Vilnius, Lithuania
    Institute of Health Sciences, Faculty of Medicine, Vilnius University, Ciurlionio g. 21, 03101 Vilnius, Lithuania)

Abstract

This retrospective cohort study aimed to analyze overall and cause-specific mortality risk in people with type 2 diabetes mellitus (T2DM) in Lithuania. Information on the diagnosis of T2DM and glucose-lowering medication was obtained from the National Health Insurance Fund database, causes of death–from death certificates. Sex, age, and calendar period-standardized mortality ratios (SMRs) were calculated. In addition, 89,512 patients were followed-up between 2010 and 2017, contributing to the observation period of 592,321 person-years. Overall mortality risk was increased for both sexes (overall SMR = 1.35, 95% confidence interval (CI) 1.34–1.37). Greatest mortality risk was in the age group of 40–49 years at diabetes diagnosis (SMR = 1.68, 95% CI 1.60–1.76) and among those who had died before the age of 50 (SMR = 22.04, 95% CI 18.82–25.81). Patients treated with insulin only had the highest SMR (2.43, 95% CI 2.32–2.55). Mortality risk increased with increasing diabetes duration and was higher in women in all these groups. The highest cause-specific SMRs were infection-related causes (SMR = 1.44), particularly septicemia (SMR = 1.78), diseases of the circulatory system (SMR = 1.42), especially ischemic heart (SMR = 1.46) and cerebrovascular diseases (SMR = 1.38), as well as diseases of the digestive system (SMR = 1.35). Cancer mortality risk was elevated for women (SMR = 1.13), but not for men (SMR = 0.93). In conclusion, people with T2DM had an excess mortality risk, which was higher in women compared to men, younger people, in those who were diagnosed with T2DM at a younger age, had longer diabetes duration, and who required treatment with insulin.

Suggested Citation

  • Donata Linkeviciute-Ulinskiene & Auguste Kaceniene & Audrius Dulskas & Ausvydas Patasius & Lina Zabuliene & Giedre Smailyte, 2020. "Increased Mortality Risk in People with Type 2 Diabetes Mellitus in Lithuania," IJERPH, MDPI, vol. 17(18), pages 1-11, September.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:18:p:6870-:d:416439
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    References listed on IDEAS

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    1. Moss, S.E. & Klein, R. & Klein, B.E.K., 1991. "Cause-specific mortality in a population-based study of diabetes," American Journal of Public Health, American Public Health Association, vol. 81(9), pages 1158-1162.
    2. Koskinen, S.V.P. & Reunanen, A.R.S. & Martelin, T.P. & Valkonen, T., 1998. "Mortality in a large population-based cohort of patients with drug- treated diabetes mellitus," American Journal of Public Health, American Public Health Association, vol. 88(5), pages 765-770.
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