Examining factors associated with excess mortality in older people (age ≥ 70 years) with diabetes - a 10-year cohort study of older people with and without diabetes

Efficient estimation of the cox model when incorporating the subgroup restricted mean survival time

The restricted mean survival time has been widely used in the field of medical research because of its clear physical and simple clinical interpretation. In this paper, we propose an efficient estimation that incorporates the auxiliary restricted mean survival information into the estimation of the proportional hazard (PH) model. Compared to conventional models that do not incorporate available auxiliary information, the proposed method improves efficiency in estimating regression parameters by utilizing the double empirical likelihood method. We prove that the estimator asymptotically follows a multivariate normal distribution with a covariance matrix that can be consistently estimated. To address scenarios where the PH assumption is violated, we also extended the method to the stratified Cox model. In addition, simulation studies show that the proposed estimators are more efficient than those derived from the conventional partial likelihood approach. A type 2 diabetes dataset is then used to evaluate the risk of antidiabetic drugs and demonstrate the proposed method.

Geriatric Syndromes in Older Adults With and Without Diabetes: A Systematic Review and Meta-Analysis

PURPOSE

Diabetes prevalence is increasing among older adults globally. The current study aimed to compare geriatric syndrome prevalence in older adults with and without diabetes.

METHOD

Primary research (2011 to 2024) in English, French, or Spanish was included. We used multiple databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled log odds ratios (ORs) and prevalence rates were calculated using random-effects models. Sensitivity analysis explored heterogeneity, and publication bias was assessed.

RESULTS

Older adults with diabetes exhibited higher prevalence rates of cognitive impairment (9.13% vs. 4.22%, log OR: 0.1884), depression (8.96% vs. 5.44%, log OR: 0.3543), falls (11.5% vs. 4.47%, log OR: 0.4237), functional impairment (14.2% vs. 10.6%, log OR: 1.02), urinary incontinence (9.72% vs. 4.35%, log OR: 1.3668), frailty (22.8% vs. 12.1%, log OR: 1.3443), and polypharmacy (22.9% vs. 5.78%, log OR: 2.5420). Diabetes was also associated with a higher comorbidity burden.

CONCLUSION

Multidisciplinary strategies addressing diabetes and associated conditions are crucial for older adults with diabetes. Future research should delve into underlying mechanisms and optimize care strategies. [Research in Gerontological Nursing, 18(2), 99-108.].

Is living alone associated with mortality among older primary care patients with or without diabetes?

AIMS

The aim of this study was to evaluate the association between living alone and mortality among older patients with and without diabetes.

METHODS

Electronic patient records were used to identify patients at least 65 years of age with a diagnosis of diabetes and two age- and sex-matched controls without diabetes for each patient with diabetes in 2015. The study population in this analysis consisted of 429 patients with diabetes and 650 controls who returned a questionnaire that contained questions about their diseases, symptoms, and functions. The mortality (2015-2019) data were based on the national registry of Statistics Finland. Cumulative mortality was estimated with Kaplan-Meier's method and compared with the log-rank test. Cox proportional hazards regression was used to estimate the adjusted hazard ratios (HR) and their 95% confidence intervals (CI).

RESULTS

The median follow-up time was 4.3 years. 208 of the controls (32%) and 156 (36%) of the patients with diabetes lived alone. Of the controls, 8.1% (95% CI 5.9-11.1) of those not living alone and 20.2% (95% CI 15.3-26.3) living alone died. The corresponding numbers for patients with diabetes were 15.1% (95% CI 11.3-19.8) and 28.8% (95% CI 22.4-36.7). Among all patients, living alone was associated with increased mortality (HR = 1.84; 95% Cl 1.30-2.61), whereas the diagnosis of diabetes was not (HR = 1.31; 95% Cl 0.94-1.81).

CONCLUSIONS

The results of this study show that living alone had a significant impact on the mortality of older patients, regardless of whether they had diabetes or not. Diabetes was not clearly associated with the increased mortality among these older home-dwelling patients.

The global burden of ischemic heart disease attributed to high fasting plasma glucose: Data from 1990 to 2019

Background

Ischemic heart disease (IHD) is the leading cause of death worldwide. High fasting plasma glucose (FPG) is an increasing risk factor for IHD. We aimed to explore the long-term trends of high FPG-attributed IHD mortality during 1990-2019.

Methods

Data were obtained from the Global Burden of Disease Study 2019 database. Deaths, disability-adjusted life-years (DALYs), the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) of IHD attributable to high FPG were estimated by sex, socio-demographic index (SDI), regions and age. Estimated annual percentage changes (EAPCs) were calculated to assess the trends of ASMR and ASDR of IHD attributable to high FPG.

Results

IHD attributable to high FPG deaths increased from 1.04 million (0.62-1.63) in 1990 to 2.35 million (1.4-3.7) in 2019, and the corresponding DALYs rose from 19.82 million (12.68-29.4) to 43.3 million (27.8-64.2). In 2019, ASMR and ASDR of IHD burden attributable to high FPG were 30.45 (17.09-49.03) and 534.8 (340.7-792.2), respectively. The highest ASMR and ASDR of IHD attributable to high FPG occurred in low-middle SDI quintiles, with 39.28 (22.40-62.76) and 742.3 (461.5-1117.5), respectively, followed by low SDI quintiles and middle SDI quintiles. Males had higher ASMR and ASDR compared to females across the past 30 years. In addition, ASRs of DALYs and deaths were highest in those over 95 years old.

Conclusion

High FPG-attributed IHD mortality and DALYs have increased dramatically and globally, particularly in low, low-middle SDI quintiles and among the elderly. High FPG remains a great concern on the global burden of IHD and effective prevention and interventions are urgently needed to curb the ranking IHD burden, especially in lower SDI regions.

Real-World Hemoglobin A1c Changes, Prescribing Provider Types, and Medication Dose Among Patients with Type 2 Diabetes Mellitus Initiating Treatment with Oral Semaglutide

INTRODUCTION

Given the lack of real-world data on oral semaglutide use outside clinical trials, the purpose of this study was to describe dose, prescriber specialty, and change in hemoglobin A1c (HbA1c) after 6 months of oral semaglutide treatment for patients with type 2 diabetes mellitus (T2DM).

METHODS

This was a retrospective study among adult patients with T2DM with ≥ 1 claim for oral semaglutide between November 1, 2019`1-June 30, 2020. Patients had continuous health plan enrollment ≥ 12 months prior to (pre-index) and ≥ 6 months following (post-index) the date of the first oral semaglutide claim (index). Dose at initiation and specialty of the prescribing provider were captured. Change in HbA1c between the last post- and pre-index HbA1c measurement was calculated. Patients were stratified by pre-index HbA1c ≥ 9% (poorly controlled) and HbA1c < 9%.

RESULTS

A total of 744 HbA1c < 9% and 268 poorly controlled patients were included in the study. Most patients had an initial oral semaglutide dose of 7 mg (49.3%) or 3 mg (42.9%), prescribed most frequently by a primary care provider (27.8%). Mean HbA1c reduction was 0.8% (p < 0.001). Patients with poorly controlled T2DM had greater HbA1c reductions than patients with HbA1c < 9% (2.0% versus 0.4%, p < 0.001). Patients persistent with oral semaglutide (≥ 90 days continuous treatment) had a mean HbA1c reduction of 0.9% (p < 0.001); persistent patients with poorly controlled T2DM had a mean reduction of 2.5%.

CONCLUSIONS

Patients with T2DM in this study experienced significant reductions in HbA1c within 6 months following initiation of oral semaglutide. Patients with a higher starting HbA1c experienced greater HbA1c reductions. The initial dose of oral semaglutide was higher than prescribing instructions indicated for more than half of the study patients.

Effectiveness of countermeasure for polypharmacy by multidisciplinary team review in patients with diabetes mellitus

AIMS/INTRODUCTION

Polypharmacy in diabetes patients is related to worse clinical outcomes. The aim of this study was to evaluate the usefulness of our countermeasure for polypharmacy, which combines a pharmacist check followed by a multidisciplinary team review in diabetic patients with polypharmacy.

METHODS

A single-center, retrospective observational study was conducted at Gifu University Hospital. Study participants included diabetic patients taking six or more drugs on admission to the diabetes ward between July 2021 and June 2022. Drugs which were discontinued by the present countermeasure were examined, and the number of drugs being taken by each patient was compared between admission and discharge.

RESULTS

102 of 308 patients were taking six or more drugs on admission. The drugs being taken by these patients were evaluated by pharmacists using a checklist for polypharmacy. Eighty-four drugs which were evaluated as inappropriate or potentially inappropriate medications by pharmacists were discontinued following the multidisciplinary team review. The median and mean number of drugs taken by the 102 patients significantly decreased from 9.0 (IQR: 8-12) and 9.26 ± 2.64 on admission to 9.0 (IQR: 6-10) and 8.42 ± 2.95 on discharge (P = 0.0002). We followed up with these patients after discontinuation of the drugs and confirmed that their clinical status had not deteriorated.

CONCLUSION

The present countermeasure for polypharmacy, which combines a pharmacist check based on a checklist for evaluating polypharmacy followed by a multidisciplinary team review, was useful for reducing the number of inappropriate or potentially inappropriate medications taken by diabetes patients with polypharmacy.

Risk of Cause-Specific Mortality across Glucose Spectrum in Elderly People: A Nationwide Population-Based Cohort Study

BACKGRUOUND

This study investigated the risk of cause-specific mortality according to glucose tolerance status in elderly South Koreans.

METHODS

A total of 1,292,264 individuals aged ≥65 years who received health examinations in 2009 were identified from the National Health Information Database. Participants were classified as normal glucose tolerance, impaired fasting glucose, newly-diagnosed diabetes, early diabetes (oral hypoglycemic agents ≤2), or advanced diabetes (oral hypoglycemic agents ≥3 or insulin). The risk of system-specific and disease-specific deaths was estimated using multivariate Cox proportional hazards analysis.

RESULTS

During a median follow-up of 8.41 years, 257,356 deaths were recorded. Diabetes was associated with significantly higher risk of all-cause mortality (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.57 to 1.60); death due to circulatory (HR, 1.49; 95% CI, 1.46 to 1.52), respiratory (HR, 1.51; 95% CI, 1.47 to 1.55), and genitourinary systems (HR, 2.22; 95% CI, 2.10 to 2.35); and neoplasms (HR, 1.30; 95% CI, 1.28 to 1.32). Diabetes was also associated with a significantly higher risk of death due to ischemic heart disease (HR, 1.70; 95% CI, 1.63 to 1.76), cerebrovascular disease (HR, 1.46; 95% CI, 1.41 to 1.50), pneumonia (HR, 1.69; 95% CI, 1.63 to 1.76), and acute or chronic kidney disease (HR, 2.23; 95% CI, 2.09 to 2.38). There was a stepwise increase in the risk of death across the glucose spectrum (P for trend <0.0001). Stroke, heart failure, or chronic kidney disease increased the risk of all-cause mortality at every stage of glucose intolerance.

CONCLUSION

A dose-dependent association between the risk of mortality from various causes and severity of glucose tolerance was noted in the elderly population.

Association of urinary phthalate metabolites with all-cause and cardiovascular disease mortality among adults with diabetes mellitus: National Health and Nutrition Examination Survey 2005-2014

Background

The study regarding phthalate metabolites and mortality among diabetes mellitus (DM) is limited. We aimed to examine the association of urinary phthalate metabolites with all-cause and cardiovascular disease (CVD) mortality among adults with DM.

Methods

This study included 8,931 adults from the National Health and Nutrition Examination Survey (NHANES) from 2005-2006 to 2013-2014. Mortality data were linked to National Death Index public access files through December 31, 2015. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidences (CIs) for mortality.

Results

We identified 1,603 adults with DM [mean ± SE age, 47.08 ± 0.30 years; 50.5% (833) were men]. Mono-(carboxynonyl) phthalate (MCNP), mono-2-ethyl-5-carboxypentyl phthalate (MECPP), and the sum of Di (2-ethylhexyl) phthalate (DEHP) metabolites (∑DEHP) were positively associated with DM (MCNP: OR = 1.53, 95%CI = 1.16-2.01; MECPP: OR = 1.17, 95% CI = 1.03-1.32; ∑DEHP: OR = 1.14, 95% CI = 1.00-1.29). Among DM patients, mono-(3-carboxypropyl) phthalate (MCPP) was associated with a 34% (HR 1.34, 95% CI 1.12-1.61) increased risk of all-cause mortality while the HRs (95%CI) of CVD mortality were 2.02 (1.13-3.64) for MCPP, 2.17 (1.26-3.75) for mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), 2.47 (1.43-4.28) for mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), 2.65 (1.51-4.63) for MECPP, and 2.56 (1.46-4.46) for ∑DEHP, respectively.

Conclusion

This study is an academic exploration of the association between urinary phthalate metabolites and mortality among adults with DM, suggesting that exposure to phthalates might be associated with an increased risk of all-cause and CVD mortality in DM. These findings suggest that patients with DM should carefully use plastics products.

Effects of Polypharmacy in Elderly Diabetic Patients: A Review

Diabetes is a chronic condition brought on by either insufficient insulin production by the pancreas or inefficient insulin utilization by the body or both. A hormone called insulin controls blood sugar. Multiple co-morbidities can arise as a result of the progressive nature of diabetes, necessitating the use of numerous medications. As one or more medications may be used to treat each ailment, the older population with multimorbidity frequently uses many medications, also known as polypharmacy. Due to polypharmacy, harmful medication interactions, and food-drug interactions can occur. Because of the numerous co-morbidities that already exist, there is an increasing tendency of prescribing polypharmacy.

Prevalence and impact of polypharmacy in older patients with type 2 diabetes

BACKGROUND

Polypharmacy is a prevalent condition in older adults, especially those with multiple chronic diseases, and has been largely associated with adverse outcomes, including disability, hospitalizations, and death.

AIMS

This systematic review focused on diabetes and aimed to investigate the prevalence and impact of polypharmacy in older adults affected by such disease.

METHODS

Observational (either cross-sectional or longitudinal) or experimental studies investigating the frequency and impact of polypharmacy in older adults with diabetes were identified from scientific databases and grey literature until August 2021. The prevalence and the 95% Confidence Interval (95% CI) of polypharmacy in older people with diabetes were summarized by a random-effects meta-analysis.

RESULTS

From a total of 1465 records, 9 were selected for the qualitative synthesis, and 8 for the quantitative synthesis. Most studies defined polypharmacy using a cut-off for the minimum number of medications ranging from 4 to 6 drugs/day. The pooled prevalence of polypharmacy in older people with diabetes was 64% (95% CI 45-80%). Considering studies that used the same definition of polypharmacy (i.e. ≥ 5 drugs/day), the pooled prevalence was 50% (95% CI 37-63%). The between-studies heterogeneity was high. Across the selected studies, polypharmacy seemed to negatively influence both diabetes-specific (poor glycemic control and risk of hypoglycemia) and health-related (risk of incident falls, syncope, hospitalization, and death) outcomes.

CONCLUSION

This systematic review confirms the high prevalence of polypharmacy in older people with diabetes and its strong impact on several health-related outcomes, including mortality. These results strengthen the need to improve care strategies for management of these patients.

What are the self-management experiences of the elderly with diabetes? A systematic review of qualitative research

BACKGROUND

The number of elderly individuals with diabetes is dramatically increasing. Diabetes is a long-term condition and a noncommunicable disease and requires intensive daily self-management. Understanding of self-management from the patients’ perspectives is important to nurses, healthcare providers, and researchers and benefits people by improving their self-management skills.

AIM

To examine and synthesize qualitative studies that explore the experiences of elderly people in self-managing diabetes.

METHODS

Electronic databases were searched, including MEDLINE, CINAH, PsycINFO, PubMed, CNKI, and WANFADATA. Relevant research was identified by manually searching reference lists and gray literature. Only English and Chinese publications were included. The Critical Appraisal Skills Program was used to assess the quality of the research. The Confidence in the Evidence from Reviews of Qualitative research approach was used to assess the confidence of the findings.

RESULTS

A total of 10 qualitative studies were included, and content analysis was performed. Five themes were identified: The need for knowledge about diabetes care, support systems, functional decline, attitudes toward diabetes, and healthy lifestyle challenges.

CONCLUSION

This present review provides a deep and broad understanding of the experiences in the self-management of diabetes and can be valuable to nursing practice and provide recommendations for future research.

Mortality and Years of Life Lost in Diabetes Mellitus and Its Subcategories in China and Its Provinces, 2005-2020

OBJECTIVES

To analyze diabetes mellitus (DM) mortality and years of life lost (YLL) in different years and different subgroups at the national and regional levels in China from 2005 to 2020.

METHODS

We estimated mortality and YLL of DM and its subcategories for 31 provinces in China during 2005-2020 using multisource data from the National Mortality Surveillance System (NMSS).

RESULTS

The age standardized mortality rate (ASMR) of DM increased from 12.18 per 100,000 in 2005 to 13.62 per 100,000 in 2020, which was an increase of 11.86%. The ASMR of type 2 diabetes mellitus (T2DM) was much higher than that of type 1 diabetes mellitus (T1DM). The ASMR of T1DM remained stable, but the rate of T2DM increased, and the increase in male patients was higher than that in their female counterparts. At the same time, the burden of premature death was highest in the group ≥ 80 years old, and ASMR increased from 236.02 per 100,000 in 2005 to 358.86 per 100,000 in 2020. In 2005, the eastern region had the highest ASMR of DM, but the western region's ASMR grew faster and eventually became the highest in 2020. In addition, the YLL rate in the eastern region showed a downward trend; however, in the middle and western regions the YLL rate continued to rise, with that of the western region rapidly increasing.

CONCLUSION

A dramatically upward trend in DM deaths can be seen in China from 2005 to 2020. DM remains a chronic disease in urgent need of prevention and control, especially in the elderly and people in less-affluent provinces. We must put forward more targeted policies to effectively allocate medical resources and focus on high-risk groups to reduce the premature-mortality burden of DM and its subcategories.

Longitudinal Associations Between Gait, Falls, and Disability in Community-Dwelling Older Adults With Type II Diabetes Mellitus: Findings From The Irish Longitudinal Study on Ageing (TILDA)

BACKGROUND

Diabetes is associated with gait deficits, future falls, and disability; however, it is unclear if associations remain after controlling for relevant confounders. This study investigated (i) the effects of type II diabetes on spatiotemporal gait parameters in community-dwelling older adults and (ii) if diabetes status was independently associated with future falls and disability, after controlling for gait and other confounders.

METHOD

Baseline data were obtained from 2608 community-dwelling adults (≥60 years) participating in The Irish Longitudinal Study on Ageing (TILDA). Diabetes was identified from self-reported doctors' diagnosis, medications, and glycated hemoglobin levels. Gait characteristics were obtained during single- and dual-task walking using a GAITRite mat (n = 2560). Incident falls and disability were collected over 4 years follow-up (n = 2473). Associations between diabetes status and gait (cross-sectional) and falls and disability (longitudinal) were investigated using regression analysis, adjusting for medications, cardiovascular health, neuropsychological function, and fall-related factors.

RESULTS

Diabetes (prevalence = 9.1%) was cross-sectionally associated with shorter dual-task step length after adjusting for covariates (β = -1.59, 95% CI: -3.10, -0.08, p < .05). Diabetes was independently associated with increased risk of future instrumental activity of daily living (IADL) difficulty in those with no prior difficulty (incidence rate ratio [IRR] = 1.51, 95% CI: 1.08, 2.11, p < .05) although dual-task step length was an important confounder in all disability models. No independent associations between diabetes and falls were observed.

CONCLUSIONS

Diabetes was independently associated with shorter dual-task step length and increased risk of future IADL difficulty. Multidimensional interventions addressing poor health and function in those with diabetes may help reduce the risk of gait deficits and future disability.

Diabetes and global ageing among 65-99-year-old adults: Findings from the International Diabetes Federation Diabetes Atlas, 9th edition

AIMS

The main aims are: (a) to draw attention to the nature and pattern of recent global and regional prevalence estimates and projections of diabetes in older adults (65-99 years), and (b) to describe the societal health implications of these changes on a global scale.

METHODS

Diabetes prevalences and projections were estimated using a logistic regression method to generate smoothed age- and sex-specific prevalence estimates for 5-year age groups.

RESULTS

In 2019, it is estimated that 19.3% of people aged 65-99 years (135.6 million, 95% CI: 107.6-170.6 million) live with diabetes. It is projected that the number of people older than 65 years (65-99 years) with diabetes will reach 195.2 million by 2030 and 276.2 million by 2045. For the regional distribution, the highest prevalence in 2019 being the North America and Caribbean Region at 27.0%. Countries with the highest number of people older than 65 years with diabetes are China, the United States of America and India.

CONCLUSIONS

There is a need for more data from national and regional sources on those aged 65 years and over, but the prevailing evidence points to diabetes being a considerable global chronic illness burden in ageing societies.

Reducing the Burden of Mortality in Older People With Diabetes: A Review of Current Research

This review considers the burden of mortality observed in the older population of people with diabetes and identifies the risk factors associated with mortality hazard in this population. The mortality gap between older people with and without diabetes is enduring, with excess mortality being 10% greater than in the general population. While early mortality in men with diabetes is significantly greater than females with diabetes, the relative mortality risk in females is much higher compared to women without diabetes. Older people who have developed diabetes in middle age have significantly higher mortality hazard compared to those who develop it in old age, emphasizing the continued importance of optimizing diabetes care in all ages. To minimize mortality hazard in older age it is important to address some of the factors that convey risk, these include: comorbidity; polypharmacy; physical and mental frailty; safe glycemic targets for older people; hypoglycemia; glycemic targets; and the hypoglycemic agents. While the data to determine optimal management approaches are limited, the overall need is for a more diligent approach in assessing the needs of older people with diabetes to inform individualized care strategies and therapy goals that minimize potential hazards.

Associations among health behaviors, body mass index, hypertension, and diabetes mellitus: A path analysis

Hypertension (HTN) and type 2 diabetes are common diseases; however, the effects of health behavior and body mass index (BMI) on their incidence and relationship are unclear. The purpose of this study was to investigate the associations among health behaviors, BMI, HTN, and type 2 diabetes.This study was a secondary data analysis using Korean Longitudinal Study of Aging data between 2010 and 2014 (third and fifth). The sample consisted of 3481 people aged 45 years or older. Path analysis was conducted using the generalized structural equation modeling of STATA 13.1 that enabled analyzing the types of binary variables and logit links.There were 129 underweight, 1714 normal, and 1638 overweight and obese individuals. In underweight and normal groups who had regular meals (B = 0.670, P < .001), BMI was higher. However, for those who were older (B = -0.041, P < .001) and female (B = -0.229, P = .021), BMI was lower. The incidence of HTN increased with age (B = 0.038, P = .001). In addition, the incidence of type 2 diabetes increased with age (B = 0.051, P = .005) and smoking (B = 1.539, P = .001). However, the incidence of type 2 diabetes was lower (B = -1.077, P = .036) for those who had regular meals. In the normal and overweight groups, BMI decreased with age (B = -0.033, P < .001). The incidence of HTN increased with age (B = 0.042, P < .001) and BMI (B = 0.145, P < .001). Moreover, the incidence of type 2 diabetes increased with age (B = 0.046, P < .001), smoking (B = 0.682, P = .020), and higher BMI (B = 0.151, P = .001).In the underweight and normal group, health behaviors were related to BMI. In the normal and overweight group, health behaviors were not related to BMI, but high BMI was related to the incidence of HTN and type 2 diabetes. Smoking has a direct effect on the incidence of type 2 diabetes. Thus, the importance of maintaining an ideal BMI and smoking cessation are highlighted.

Examining trends in type 2 diabetes incidence, prevalence and mortality in the UK between 2004 and 2014

AIMS

Contemporary data describing type 2 diabetes prevalence, incidence and mortality are limited. We aimed to (1) estimate annual incidence and prevalence rates of type 2 diabetes in the UK between 2004 and 2014, (2) examine relationships between observed rates with age, gender, socio-economic status and geographic region, and (3) assess how temporal changes in incidence and all-cause mortality rates influence changes in prevalence.

METHODS

Type 2 diabetes patients aged ≥16 years between January 2004 and December 2014 were identified using the Clinical Practice Research Datalink (CPRD). Up to 5 individuals without diabetes were matched to diabetes patients based on age, gender and the general practice. Annual incidence, prevalence and mortality rates were calculated per 10 000 person-years at risk (95% CI). Survival models compared mortality rates in patients with and without type 2 diabetes.

RESULTS

Prevalence rates of type 2 diabetes increased from 3.21% (3.19; 3.22) in 2004 to 5.26% (5.24; 5.29) in 2014. Incidence rates remained stable, overall, throughout the study period. Higher incidence and prevalence rates were related to male gender and deprivation. Individuals with type 2 diabetes were associated with higher risk of mortality (Hazard ratio 1.26 [1.20; 1.32]). Mortality rates declined in patients with and without diabetes throughout the study period. The incidence and prevalence of type 2 diabetes in patients aged 16 to 34 years increased over time.

CONCLUSIONS

The rising prevalence of type 2 diabetes in the UK over the last decade is probably explained by patients living longer rather than by increasing incidence of type 2 diabetes.