Diabetologia: Time Trends in Deaths before age 50 for People with Type 1 Diabetes - Based on a national analysis of Scotland 2004-2017

The purpose of this study is to study whether the crude mortality rate of people with type 1 diabetes has improved in recent years relative to the general population under 50 years of age.
, at any time between 2004 and 2017 people under the age of 50 and at least one year of age with type 1 diabetes were identified using the National Register.
death data are obtained through contact with the National Death Register of Scotland.
indirect age standardization is used to calculate gender-specific standardized mortality (SMr).
poisson regression was used to test the rate of occurrence of calendar time effects (IRRs).
of the 27,935 people with type 1 diabetes, 1,138 died in 251,143 years.
over time, mortality declined significantly (the internal rate of return for the calendar year was 0.983 (95 per cent with a confidence interval of 0.967, 0.998) and p was 0.03), smR remained generally stable in 2004 and 2017, with 3.1 and 3.6 for men and 4.09 and 4.16 for women, respectively.
diabetic ketoacidosis or coma (DKAoC) accounted for 22% of deaths and there was no significant decrease in incidence (IRR 0.975 (95% CI 0.94, 1.011), p s 0.168);
diseases accounted for 27% of deaths and did decrease significantly (IRR 0.946 (95% confidence interval 0.914,0.979) and p s 0.002).
that although absolute mortality rates have declined, the relative effects of type 1 diabetes on under-50 mortality have not improved.
it makes sense to improve the prevention of early circulatory diseases and d-hyperglycemia, and to develop more effective strategies for people with type 1 diabetes to avoid clinically significant high or low blood sugar.
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