title: Long-term Mortality and End-Stage Renal Disease in a Type 1 Diabetes Population Diagnosed at Age 15-29 Years in Norway.
abstract: To study long-term mortality, causes of death, and end-stage renal disease (ESRD) in people diagnosed with type 1 diabetes at age 15-29 years.
  
  
  
  This nationwide, population-based cohort with type 1 diabetes diagnosed during 1978-1982 (n = 719) was followed from diagnosis until death, emigration, or September 2013. Linkages to the Norwegian Cause of Death Registry and the Norwegian Renal Registry provided information on causes of death and whether ESRD was present. A clinical committee reviewed the causes of death. We calculated standardized mortality ratios (SMRs) for comparison with the background population.
  
  
  
  During 30 years' follow-up, 4.6% of participants developed ESRD and 20.6% (n = 148; 106 men and 42 women) died. Cumulative mortality by years since diagnosis was 6.0% (95% CI 4.5-8.0) at 10 years, 12.2% (10.0-14.8) at 20 years, and 18.4% (15.8-21.5) at 30 years. The SMR was 4.4 (95% CI 3.7-5.1). Mean time from diagnosis of diabetes to ESRD was 23.6 years (range 14.2-33.5). Death was caused by chronic complications (32.2%), acute complications (20.5%), violent death (19.9%), or any other cause (27.4%). Death was related to alcohol in 15% of cases. SMR for alcohol-related death was 6.8 (95% CI 4.5-10.3), for cardiovascular death was 7.3 (5.4-10.0), and for violent death was 3.6 (2.3-5.3).
  
  
  
  The cumulative incidence of ESRD was low in this cohort with type 1 diabetes followed for 30 years. Mortality was 4.4 times that of the general population, and more than 50% of all deaths were caused by acute or chronic complications. A relatively high proportion of deaths were related to alcohol.
authors: Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway vibeke.gagnum@ous-hf.no.|Oslo Diabetes Research Centre, Oslo, Norway.
authors: Vibeke
authors: V
authors: Gagnum
authors: Oslo Diabetes Research Centre, Oslo, Norway.|Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors: Lars C
authors: LC
authors: Stene
authors: Norwegian Renal Registry, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
authors: Torbjørn
authors: T
authors: Leivestad
authors: Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.|Oslo Diabetes Research Centre, Oslo, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors: Geir
authors: G
authors: Joner
authors: Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.|Oslo Diabetes Research Centre, Oslo, Norway.|Norwegian Childhood Diabetes Registry, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
authors: Torild
authors: T
authors: Skrivarhaug
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002423:Cause of Death; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012042:Registries; D013997:Time Factors; D055815:Young Adult