03669nas a2200529 4500008004100000022001400041245007400055210006900129260001600198300001200214490000800226520220200234653001802436653001902454653002202473653001102495653001102506653001802517653002002535653000902555653001602564653000902580653002202589100003702611700002102648700002402669700003002693700001302723700001902736700002202755700002402777700002302801700001702824700002102841700002102862700001902883700002102902700001802923700002402941700002302965700001902988700002203007700001703029700001703046710004003063856003603103 2011 eng d a1533-440600aDiabetes mellitus, fasting glucose, and risk of cause-specific death.0 aDiabetes mellitus fasting glucose and risk of causespecific deat c2011 Mar 03 a829-8410 v3643 a
BACKGROUND: The extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain.
METHODS: We calculated hazard ratios for cause-specific death, according to baseline diabetes status or fasting glucose level, from individual-participant data on 123,205 deaths among 820,900 people in 97 prospective studies.
RESULTS: After adjustment for age, sex, smoking status, and body-mass index, hazard ratios among persons with diabetes as compared with persons without diabetes were as follows: 1.80 (95% confidence interval [CI], 1.71 to 1.90) for death from any cause, 1.25 (95% CI, 1.19 to 1.31) for death from cancer, 2.32 (95% CI, 2.11 to 2.56) for death from vascular causes, and 1.73 (95% CI, 1.62 to 1.85) for death from other causes. Diabetes (vs. no diabetes) was moderately associated with death from cancers of the liver, pancreas, ovary, colorectum, lung, bladder, and breast. Aside from cancer and vascular disease, diabetes (vs. no diabetes) was also associated with death from renal disease, liver disease, pneumonia and other infectious diseases, mental disorders, nonhepatic digestive diseases, external causes, intentional self-harm, nervous-system disorders, and chronic obstructive pulmonary disease. Hazard ratios were appreciably reduced after further adjustment for glycemia measures, but not after adjustment for systolic blood pressure, lipid levels, inflammation or renal markers. Fasting glucose levels exceeding 100 mg per deciliter (5.6 mmol per liter), but not levels of 70 to 100 mg per deciliter (3.9 to 5.6 mmol per liter), were associated with death. A 50-year-old with diabetes died, on average, 6 years earlier than a counterpart without diabetes, with about 40% of the difference in survival attributable to excess nonvascular deaths.
CONCLUSIONS: In addition to vascular disease, diabetes is associated with substantial premature death from several cancers, infectious diseases, external causes, intentional self-harm, and degenerative disorders, independent of several major risk factors. (Funded by the British Heart Foundation and others.).
10aBlood Glucose10aCause of Death10aDiabetes Mellitus10aFemale10aHumans10aHyperglycemia10aLife Expectancy10aMale10aMiddle Aged10aRisk10aSurvival Analysis1 aSeshasai, Sreenivasa, Rao Kondap1 aKaptoge, Stephen1 aThompson, Alexander1 aDi Angelantonio, Emanuele1 aGao, Pei1 aSarwar, Nadeem1 aWhincup, Peter, H1 aMukamal, Kenneth, J1 aGillum, Richard, F1 aHolme, Ingar1 aNjølstad, Inger1 aFletcher, Astrid1 aNilsson, Peter1 aLewington, Sarah1 aCollins, Rory1 aGudnason, Vilmundur1 aThompson, Simon, G1 aSattar, Naveed1 aSelvin, Elizabeth1 aHu, Frank, B1 aDanesh, John1 aEmerging Risk Factors Collaboration uhttps://chs-nhlbi.org/node/1272