title: Survival in patients with type 2 diabetes in a Swedish community: skaraborg hypertension and diabetes project.
abstract: OBJECTIVE
  To explore risk factors for all-cause mortality in patients with type 2 diabetes treated in primary care.
  
  
  METHODS
  A prospective population-based study of 400 patients with type 2 diabetes who consecutively completed an annual checkup in primary care in Skara, Sweden, during 1992-1993. Vital status was ascertained to year 2000. Baseline characteristics as predictors for mortality were analyzed by Cox regression and expressed as relative risks (RRs), with 95% CIs.
  
  
  RESULTS
  During a mean follow-up time of 5.9 years, 131 patients died (56 deaths per 1,000 patients per year). In both sexes, all-cause mortality was predicted by HbA(1c) (by 1%; RR 1.14, 95% CI 1.01-1.27), and by LDL-to-HDL cholesterol ratios (1.15, 1.00-1.32). Increased mortality was also seen with prevalent hypertension (1.72, 1.21-2.44), microalbuminuria (1.87, 1.27-2.76), and previous cardiovascular disease (1.70, 1.15-2.50). Subanalyses revealed that increased mortality related to HbA(1c) was restricted to hypertensive patients with type 2 diabetes (1.23, 1.04-1.47). Serum triglycerides (by 1 mmol/l) predicted all-cause mortality in women (1.25, 1.06-1.47).
  
  
  CONCLUSIONS
  Poor glucose and lipid control and hypertension predicted all-cause mortality. Survival was also predicted by prevalent microalbuminuria and by previous cardiovascular disease. Confirming results from clinical trials, this population-based study has implications for primary and secondary prevention.
authors.affiliation: Department of Community Medicine, Malmö University Hospital, Malmö, Sweden. Odeshög Health Care Centre, Sweden. Skaraborg Institute, Skövde, Sweden.
authors.forename: Carl Johan
authors.initials: CJ
authors.lastname: Ostgren
authors.forename: Ulf
authors.initials: U
authors.lastname: Lindblad
authors.forename: Arne
authors.initials: A
authors.lastname: Melander
authors.forename: Lennart
authors.initials: L
authors.lastname: Råstam
mesh_terms: D000419:Albuminuria / Q000401:mortality / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D011320:Primary Health Care; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology