title: Mortality risk in admitted patients with diabetes mellitus according to treatment.
abstract: Investigate the importance of treating diabetes by evaluating mortality risk of untreated and medically-treated diabetic patients.
  
  
  
  Historical prospectively collected observational data of hospitalized patient ≥18years, admitted for any-cause to medical wards, between January 2011 and December 2013. Main outcome was all-cause mortality at end of follow-up.
  
  
  
  Cohort included 35,340 patients (51% male, median age 70years); 24,159 without diabetes and 11,181 with diabetes. Within the diabetic group, 2,188 patients (20%) were not receiving medical treatment for diabetes and 8993 were being treated as follows: 4550 (41%) non-insulin monotherapy; 1550 (14%) non-insulin combination therapy; 2,893 (26%) insulin. Hazard ratios were compared for the entire follow-up, indicating a significant difference in overall survival between medically untreated DM and all groups, except insulin-treated. Subset analysis with adjustment for age, gender, BMI, alcohol and smoking indicated a significant survival difference between untreated DM and all groups. Rates of hypertension, ischemic heart disease, renal failure, and congestive heart disease were higher in the untreated and insulin-treated diabetic patients than in the nondiabetic and diabetic patients on non-insulin treatment.
  
  
  
  Lack of treatment for diabetes might have serious consequences. Further studies are needed to see if targeted treatment approach may decrease mortality.
authors.affiliation: Institute of Endocrinology, Rabin Medical Center - Beilinson Hospital, Petach Tikva 49100; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: amit.akirov@gmail.com.
authors.forename: Amit
authors.initials: A
authors.lastname: Akirov
authors.affiliation: Department of Internal Medicine D, Rabin Medical Center - Beilinson Hospital, Petach Tikva 49100; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Dror
authors.initials: D
authors.lastname: Dicker
authors.affiliation: Statistical Consulting Unit, Rabin Medical Center, Beilinson Hospital.
authors.forename: Tzipora
authors.initials: T
authors.lastname: Shochat
authors.affiliation: Institute of Endocrinology, Rabin Medical Center - Beilinson Hospital, Petach Tikva 49100; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Shimon
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D009026:Mortality; D051437:Renal Insufficiency / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D007328:Insulin
keywords: Admission; Diabetes mellitus; Insulin; Mortality; Oral Hypoglycemic Drugs