title: All-cause mortality in a nationwide cohort of childhood-onset diabetes in Norway 1973-2013.
abstract: OBJECTIVE
  The aim of this study was to assess the association between all-cause mortality and sex, age at diagnosis and year of diagnosis in Norwegian patients with childhood-onset diabetes.
  
  
  METHODS
  The study was based on the nationwide, population-based Norwegian Childhood Diabetes Registry, which includes all newly diagnosed cases of childhood-onset diabetes at age 0-14 years in 1973-1982 and 1989-2012 (n = 7,884). Patients were followed until date of death, emigration or 30 September 2013.
  
  
  RESULTS
  Among the 7,884 patients, representing 132,420 person-years, 249 (3.2%) died during a mean follow-up of 16.8 (range 0.0-40.7) years. The standardised mortality ratio (SMR) for the total cohort was 3.6 (95% CI 3.1, 4.0), increasing by attained age. Absolute mortality was significantly lower in females than in males (HR 0.50 [95% CI 0.38, 0.65]), although the SMRs were similar. Cox regression analysis showed a significant decrease in mortality of 49% (HR 0.51 [95% CI 0.28, 0.93]) for those diagnosed in 1999-2012 compared with those diagnosed in 1973-1982 (p = 0.03).
  
  
  CONCLUSIONS
  In spite of improved diabetes care, mortality is still three to four times higher in those with childhood-onset diabetes compared with the general population in Norway. However, absolute mortality has declined among children diagnosed most recently (1999-2012) compared with those diagnosed in the earliest period (1973-1982).
authors.affiliation: Department of Paediatrics, Oslo University Hospital, PO Box 4950, Nydalen, N-0424, Oslo, Norway, Vibeke.Gagnum@ous-hf.no.
authors.forename: Vibeke
authors.initials: V
authors.lastname: Gagnum
authors.forename: Lars C
authors.initials: LC
authors.lastname: Stene
authors.forename: Leiv
authors.initials: L
authors.lastname: Sandvik
authors.forename: Morten W
authors.initials: MW
authors.lastname: Fagerland
authors.forename: Pål R
authors.initials: PR
authors.lastname: Njølstad
authors.forename: Geir
authors.initials: G
authors.lastname: Joner
authors.forename: Torild
authors.initials: T
authors.lastname: Skrivarhaug
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012042:Registries; D055815:Young Adult