Standardised mortality is increased three-fold in a population-based sample of children and adolescents with type 1 diabetes

Authors

  • Michael Joseph O'Grady,

    1. Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
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  • Joanna Delaney,

    1. Department of Social Work, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
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  • Timothy William Jones,

    1. Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
    2. Telethon Institute of Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia
    3. School of Paediatrics and Child Health, University of Western Australia, Nedlands, Western Australia, Australia
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  • Elizabeth Ann Davis

    Corresponding author
    1. Telethon Institute of Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia
    2. School of Paediatrics and Child Health, University of Western Australia, Nedlands, Western Australia, Australia
    • Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
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Corresponding author:

Dr Elizabeth Davis, Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Roberts Road, Subiaco, Western Australia 6008,

Australia.

Tel: +61 8 9340 8090;

fax: +61 8 9340 8605;

e-mail: Elizabeth.Davis@health.wa.gov.au

Abstract

There are no type 1 diabetes (T1DM) mortality data on Australian children and limited contemporary data on their international counterparts. Fatalities in children and adolescents (1–17 yr) with T1DM were identified from the Western Australia Children's Diabetes Database between 1987–2011. Seventeen thousand four hundred and fifty-three patient-years of diabetes data were analysed and 13 deaths were confirmed (six male). The overall standardised mortality ratio was 3.1 [95% confidence interval (CI), 1.7–5.3] and was highest in the 10–14 yr age group, at 4.6 (95% CI, 1.5–10.8). Median age at death was 16.4 yr (range 5 to 17.8 yr), and median haemoglobin A1c at death was 10.5% (range 6.7 to >14). Cause of death was attributed to diabetes in 10 (77%) cases. Two patients were found ‘dead-in-bed’. All diabetes-related deaths in subjects with known T1DM occurred outside the hospital setting.

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