title: Determinants of mortality in patients with type 2 diabetes: a review.
abstract: We aimed to review and summarize the evidence from accomplished trials analyzing factors influencing mortality in patients with T2DM and to provide some recommendations for targets and treatment in the European region. The following databases were searched for relevant trials: PubMed and the Cochrane Library. Of 3.806 citations, 134 trials met our inclusion criteria.
  
  
  
  The reduction in lifetime for 65 + -years-old patients having less than 10 years T2DM amounts to 1.8 years. Having T2DM for more than 10 years lifetime will be reduced by 2.7 years. However, the lifetime shortening factor of T2DM will even be stronger for 40 + -years-old patients at onset. Males will lose 11.6 years of life and 18.6 QUALYs. T2DM among females will reduce life by 14 QUALYs by 22 years. From a statistical point of view, the highest mortality rate will occur in an over 55-years-old European smoking and non-compliant diabetic woman with alcohol abuse living in a rural area with a low level of education and a low socio-economic status. Furthermore, other co-morbidities such as cardiovascular diseases, gout, and depression affect mortality. Additionally, mortality will increase with a BMI over 35 and also with a BMI under 20-25. This refers to the obesity paradox indicating a higher mortality rate among normal weight patients with T2DM compared to overweight patients with T2DM. HbA1c-levels between 6.5 % and 7 % are associated with the lowest impact on mortality.
authors.affiliation: Health Sciences/Public Health, Faculty of Medicine, TUD, Fetscherstraße 74, D-01307, Dresden, Germany.
authors.forename: Jana
authors.initials: J
authors.lastname: Engelmann
authors.affiliation: Health Sciences/Public Health, Faculty of Medicine, TUD, Fetscherstraße 74, D-01307, Dresden, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Manuwald
authors.affiliation: Health Sciences/Public Health, Faculty of Medicine, TUD, Fetscherstraße 74, D-01307, Dresden, Germany.
authors.forename: Constanze
authors.initials: C
authors.lastname: Rubach
authors.affiliation: Health Sciences/Public Health, Faculty of Medicine, TUD, Fetscherstraße 74, D-01307, Dresden, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Kugler
authors.affiliation: Medical Clinic III, University Clinic, Faculty of Medicine, TUD, Fetscherstraße 74, D-01307, Dresden, Germany.|Study Center Prof. Hanefeld, Research for Metabolic Vascular Syndrome, GWT-TUD GmbH, Fiedlerstraße 34, D-01307, Dresden, Germany.
authors.forename: Andreas L
authors.initials: AL
authors.lastname: Birkenfeld
authors.affiliation: Study Center Prof. Hanefeld, Research for Metabolic Vascular Syndrome, GWT-TUD GmbH, Fiedlerstraße 34, D-01307, Dresden, Germany.
authors.forename: Markolf
authors.initials: M
authors.lastname: Hanefeld
authors.affiliation: Health Sciences/Public Health, Faculty of Medicine, TUD, Fetscherstraße 74, D-01307, Dresden, Germany. ulrike.rothe@tu-dresden.de.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Rothe
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019057:Quality-Adjusted Life Years
keywords: Determinants; Life expectancy; Lifetime; Mortality; Survival; T2DM