Research Article 
The excess mortality related to cardiovascular diseases and cancer among adults pharmacologically treated for diabetes-the 2001-2006 ENTRED cohort
I. Romon, G. Rey, L. Mandereau-Bruno, A. Weill, E. Jougla, E. Eschwege, D. Simon, C. Druet and A. Fagot-Campagna
Diabetic Medicine, 2014, 31(8), 946-953. DOI: 10.1111/dme.12435
Abstract
Aims
To compare the 5-year mortality (overall and cause-specific) of a cohort of adults pharmacologically treated for diabetes with that of the rest of the French adult population.
Methods
In 2001, 10 000 adults treated for diabetes were randomly selected from the major French National Health Insurance System database. Vital status and causes of death were successfully extracted from the national registry for 9101 persons. We computed standardized mortality ratios.
Results
Over 5 years, 1388 adults pharmacologically treated for diabetes died (15% of the cohort, 32.4/1000 person-years). An excess mortality, which decreased with age, was found for both genders [standardized mortality ratio 1.45 (1.37-1.52)]. Excess mortality was related to: hypertensive disease [2.90 (2.50-3.33)], ischaemic heart disease [2.19 (1.93-2.48)], cerebrovascular disease [1.76 (1.52-2.03)], renal failure [2.14 (1.77-2.56)], hepatic failure [2.17 (1.52-3.00)] in both genders and septicaemia among men [1.56 (1.15-2.09)]. An association was also found with cancer-related mortality: liver cancer in men [3.00 (2.10-4.15)]; pancreatic cancer in women [3.22 (1.94-5.03)]; colon/rectum cancer in both genders [1.66 (1.28-2.12)]. Excess mortality was not observed for breast, lung or stomach cancers.
Conclusions
Adults pharmacologically treated for diabetes had a 45% increased risk of mortality at 5 years, mostly related to cardiovascular complications, emphasizing the need for further prevention. The increased risk of mortality from cancer raises questions about the relationship between cancer and diabetes and prompts the need for improved cancer screening in people with diabetes.
ASCI-ID: 109-1557
Similar Articles
Glycated haemoglobin and cardiovascular outcomes in people with Type 2 diabetes: a large prospective cohort study
Diabetic Medicine, 2008, 25(11), 1295-1301. DOI: 10.1111/j.1464-5491.2008.02581.x
How much might cardiovascular disease risk be reduced by intensive therapy in people with screen-detected diabetes?Diabetic Medicine, 2008, 25(12), 1433-1439. DOI: 10.1111/j.1464-5491.2008.02600.x
Are there differences in cardiovascular and metabolic risk profiles among men and women with Type 2 diabetes? A cross-sectional analysisDiabetic Medicine, 2010, 27(10), 1212-1214. DOI: 10.1111/j.1464-5491.2010.03077.x
Associations between surrogate measures of insulin resistance and waist circumference, cardiovascular risk and the metabolic syndrome across Hispanic and non-Hispanic white populationsDiabetic Medicine, 2012, 29(11), 1390-1394. DOI: 10.1111/j.1464-5491.2012.03723.x
Adverse cardiovascular events during treatment with glyburide (glibenclamide) or gliclazide in a high-risk populationDiabetic Medicine, 2012, 29(12), 1524-1528. DOI: 10.1111/j.1464-5491.2012.03772.x
Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors: a report from the DPP Outcomes StudyDiabetic Medicine, 2013, 30(1), 46-55. DOI: 10.1111/j.1464-5491.2012.03750.x
Changes in physical activity and modelled cardiovascular risk following diagnosis of diabetes: 1-year results from the ADDITION-Cambridge trial cohortDiabetic Medicine, 2013, 30(2), 233-238. DOI: 10.1111/j.1464-5491.2012.03765.x
Cardiovascular effects of GLP-1 and GLP-1-based therapies: implications for the cardiovascular continuum in diabetes?Diabetic Medicine, 2013, 30(3), 289-299. DOI: 10.1111/j.1464-5491.2012.03746.x
Retracted: Effects of fasting blood glucose, diabetes treatment, blood pressure and anti-hypertension treatment on cardiovascular disease incidence: a 30-year follow-up study of 740 incident patients with Type 2 diabetesDiabetic Medicine, 2013, 30(3), 349-357. DOI: 10.1111/dme.12106
Sulphonylureas and risk of cardiovascular disease: systematic review and meta-analysisDiabetic Medicine, 2013, 30(10), 1160-1171. DOI: 10.1111/dme.12232
Biological variation of cardiovascular risk factors in patients with diabetesDiabetic Medicine, 2013, 30(10), 1172-1180. DOI: 10.1111/dme.12160
Changes in diet, cardiovascular risk factors and modelled cardiovascular risk following diagnosis of diabetes: 1-year results from the ADDITION-Cambridge trial cohortDiabetic Medicine, 2014, 31(2), 148-155. DOI: 10.1111/dme.12316
Physiological serum bilirubin concentrations are inversely associated with the prevalence of cardiovascular autonomic neuropathy in patients with Type 2 diabetesDiabetic Medicine, 2014, 31(2), 185-191. DOI: 10.1111/dme.12338
Cardiovascular disease risk factors in the South Asian population living in Kuwait: a cross-sectional studyDiabetic Medicine, 2014, 31(5), 531-539. DOI: 10.1111/dme.12386
Factors associated with statin treatment for the primary prevention of cardiovascular disease in people within 2 years following diagnosis of diabetes in Scotland, 2006-2008Diabetic Medicine, 2014, 31(6), 640-646. DOI: 10.1111/dme.12409
Does early intensive multifactorial therapy reduce modelled cardiovascular risk in individuals with screen-detected diabetes? Results from the ADDITION-Europe cluster randomized trialDiabetic Medicine, 2014, 31(6), 647-656. DOI: 10.1111/dme.12410
Type 2 diabetes mellitus and obesity in young adults: the extreme phenotype with early cardiovascular dysfunctionDiabetic Medicine, 2014, 31(7), 794-798. DOI: 10.1111/dme.12431
Association of physical activity with glycaemic control and cardiovascular risk profile in 65 666 people with Type 2 diabetes from Germany and AustriaDiabetic Medicine, 2014, 31(8), 905-912. DOI: 10.1111/dme.12438
Cardiovascular risk profiles in relation to newly diagnosed Type 2 diabetes diagnosed by either glucose or HbA1c criteria in Chinese adults in Qingdao, ChinaDiabetic Medicine, 2014, 31(8), 920-926. DOI: 10.1111/dme.12498