title: Increased mortality in a Danish cohort of young people with Type 1 diabetes mellitus followed for 24 years.
abstract: To determine the mortality rate in a Danish cohort of children and adolescents diagnosed with Type 1 diabetes mellitus compared with the general population.
  
  
  
  In 1987 and 1989 we included 884 children and 1020 adolescents aged 20 years and under, corresponding to 75% of all Danish children and adolescents with Type 1 diabetes, in two nationwide studies in Denmark. Those who had participated in both investigations (n = 720) were followed until 1 January 2014, using the Danish Civil Registration System on death certificates and emigration. We derived the expected number of deaths in the cohort, using population data values from Statistics Denmark to calculate the standardized mortality ratio. Survival analysis was performed using Cox proportional hazards model.
  
  
  
  During the 24 years of follow-up, 49 (6.8%) patients died, resulting in a standardized mortality ratio of 4.8 (95% confidence interval 3.5, 6.2) compared with the age-standardized general population. A 1% increase in baseline HbA1c(1989), available in 718 of 720 patients, was associated with all-cause mortality (hazard ratio = 1.38; 95% confidence interval 1.2, 1.6; P < 0.0001). Type 1 diabetes with multiple complications was the most common reported cause of death (36.7%).
  
  
  
  We found an increased mortality rate in this cohort of children and adolescents with Type 1 diabetes compared with the general population. The only predictor for increased risk of death up to 24 years after inclusion was the HbA1clevel in 1989. This emphasizes the importance of achieving optimal metabolic control in young people with Type 1 diabetes.
authors.affiliation: Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
authors.forename: K
authors.identifier: 0000-0002-0071-3575
authors.initials: K
authors.lastname: Sandahl
authors.affiliation: Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
authors.forename: L B
authors.initials: LB
authors.lastname: Nielsen
authors.affiliation: Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Svensson
authors.affiliation: Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark.|Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Johannesen
authors.affiliation: Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark.|Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: F
authors.initials: F
authors.lastname: Pociot
authors.affiliation: Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark.|Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: H B
authors.initials: HB
authors.lastname: Mortensen
authors.affiliation: Department of Epidemiology, Biostatistics and Biodemography, Odense University Hospital, Odense, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Hougaard
authors.affiliation: Department of Ophthalmology, Odense University Hospital, Odense, Denmark.|The Clinical Research Institute, University of Southern Denmark, Odense, Denmark.|OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark.
authors.forename: R
authors.initials: R
authors.lastname: Broe
authors.affiliation: Department of Ophthalmology, Odense University Hospital, Odense, Denmark.|The Clinical Research Institute, University of Southern Denmark, Odense, Denmark.|OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark.
authors.forename: M L
authors.initials: ML
authors.lastname: Rasmussen
authors.affiliation: Department of Ophthalmology, Odense University Hospital, Odense, Denmark.|The Clinical Research Institute, University of Southern Denmark, Odense, Denmark.|OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Grauslund
authors.affiliation: Department of Ophthalmology, Odense University Hospital, Odense, Denmark.|NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: T
authors.initials: T
authors.lastname: Peto
authors.affiliation: Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
authors.forename: B S
authors.initials: BS
authors.lastname: Olsen
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D048909:Diabetes Complications / Q000401:mortality / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D009026:Mortality; D011446:Prospective Studies; D012042:Registries; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human