title: Life expectancy in a large cohort of type 2 diabetes patients treated in primary care (ZODIAC-10).
abstract: BACKGROUND
  Most longitudinal studies showed increased relative mortality in individuals with type 2 diabetes mellitus until now. As a result of major changes in treatment regimes over the past years, with more stringent goals for metabolic control and cardiovascular risk management, improvement of life expectancy should be expected. In our study, we aimed to assess present-day life expectancy of type 2 diabetes patients in an ongoing cohort study.
  
  
  RESULTS
  We included 973 primary care type 2 diabetes patients in a prospective cohort study, who were all participating in a shared care project in The Netherlands. Vital status was assessed from May 2001 till May 2007. Main outcome measurement was life expectancy assessed by transforming actual survival time to standardised survival time allowing adjustment for the baseline mortality rate of the general population. At baseline, mean age was 66 years, mean HbA(1c) 7.0%. During a median follow-up of 5.4 years, 165 patients died (78 from cardiovascular causes), and 17 patients were lost to follow-up. There were no differences in life expectancy in subjects with type 2 diabetes compared to life expectancy in the general population. In multivariate Cox regression analyses, concentrating on the endpoints 'all-cause' and cardiovascular mortality, a history of cardiovascular disease: hazard ratio (HR) 1.71 (95% confidence interval (CI) 1.23-2.37), and HR 2.59 (95% CI 1.56-4.28); and albuminuria: HR 1.72 (95% CI 1.26-2.35), and HR 1.83 (95% CI 1.17-2.89), respectively, were significant predictors, whereas smoking, HbA(1c), systolic blood pressure and diabetes duration were not.
  
  
  CONCLUSIONS
  This study shows a normal life expectancy in a cohort of subjects with type 2 diabetes patients in primary care when compared to the general population. A history of cardiovascular disease and albuminuria, however, increased the risk of a reduction of life expectancy. These results show that, in a shared care environment, a normal life expectancy is achievable in type 2 diabetes patients.
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Lutgers
authors.forename: Esther G
authors.initials: EG
authors.lastname: Gerrits
authors.forename: Wim J
authors.initials: WJ
authors.lastname: Sluiter
authors.forename: Lielith J
authors.initials: LJ
authors.lastname: Ubink-Veltmaat
authors.forename: Gijs W D
authors.initials: GW
authors.lastname: Landman
authors.forename: Thera P
authors.initials: TP
authors.lastname: Links
authors.forename: Reinold O B
authors.initials: RO
authors.lastname: Gans
authors.forename: Andries J
authors.initials: AJ
authors.lastname: Smit
authors.forename: Henk J G
authors.initials: HJ
authors.lastname: Bilo
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality*; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models