Mortality of South Asian patients with insulin-treated diabetes mellitus in the United Kingdom: a cohort study

A. J. Swerdlow, S. P. Laing, I. dos Santos Silva, S. D. Slater, A. C. Burden, J. L. Botha, Norman Robert Waugh, A. D. Morris, W. Gatling, P. J. Bingley, C. C. Patterson

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Aims To investigate mortality in South Asian patients with insulin-treated diabetes and compare it with mortality in non South Asian patients and in the general population.

Methods A prospective cohort study was conducted of 828 South Asian and 27 962 non South Asian patients in the UK with insulin-treated diabetes diagnosed at ages under 50 years. The patients were followed for up to 28 years. Ethnicity was determined by analysis of names. Standardized mortality ratios (SMRs) were calculated, comparing mortality in the cohort with expectations from the mortality experience of the general population.

Results SMRs were significantly raised in both groups of patients, particularly the South Asians, and especially in women and subjects with diabetes onset at a young age. The SMRs for South Asian patients diagnosed under age 30 years were 3.9 (95% CI 2.0-6.9) in men and 10.1 (5.6-16.6) in women, and in the corresponding non South Asians were 2.7 (2.6-2.9) and 4.0 (3.6-4.3), respectively. The SMR in women was highly significantly greater in South Asians than non South Asians. The mortality in the young-onset patients was due to several causes, while that in the patients diagnosed at ages 30-49 was largely due to cardiovascular disease, which accounted for 70% of deaths in South Asian males and 73% in females.

Conclusions South Asian patients with insulin-treated diabetes suffer an exceptionally high mortality. Clarification of the full reasons for this mortality are needed, as are measures to reduce levels of known cardiovascular disease risk factors in these patients.

Original languageEnglish
Pages (from-to)845-855
Number of pages10
JournalDiabetic Medicine
Volume21
Issue number8
DOIs
Publication statusPublished - 2004

Keywords

  • cohort
  • insulin-treated diabetes mellitus
  • mortality
  • South Asians
  • CORONARY-HEART-DISEASE
  • RISK-FACTORS
  • CARDIOVASCULAR-DISEASE
  • MYOCARDIAL-INFARCTION
  • ETHNIC-DIFFERENCES
  • CLINICAL-FEATURES
  • EUROPEAN ORIGIN
  • PREVALENCE
  • LONDON
  • COMPLICATIONS

Cite this

Swerdlow, A. J., Laing, S. P., dos Santos Silva, I., Slater, S. D., Burden, A. C., Botha, J. L., ... Patterson, C. C. (2004). Mortality of South Asian patients with insulin-treated diabetes mellitus in the United Kingdom: a cohort study. Diabetic Medicine, 21(8), 845-855. https://doi.org/10.1111/j.1464-5491.2004.01253.x

Mortality of South Asian patients with insulin-treated diabetes mellitus in the United Kingdom: a cohort study. / Swerdlow, A. J.; Laing, S. P.; dos Santos Silva, I.; Slater, S. D.; Burden, A. C.; Botha, J. L.; Waugh, Norman Robert; Morris, A. D.; Gatling, W.; Bingley, P. J.; Patterson, C. C.

In: Diabetic Medicine, Vol. 21, No. 8, 2004, p. 845-855.

Research output: Contribution to journalArticle

Swerdlow, AJ, Laing, SP, dos Santos Silva, I, Slater, SD, Burden, AC, Botha, JL, Waugh, NR, Morris, AD, Gatling, W, Bingley, PJ & Patterson, CC 2004, 'Mortality of South Asian patients with insulin-treated diabetes mellitus in the United Kingdom: a cohort study', Diabetic Medicine, vol. 21, no. 8, pp. 845-855. https://doi.org/10.1111/j.1464-5491.2004.01253.x
Swerdlow, A. J. ; Laing, S. P. ; dos Santos Silva, I. ; Slater, S. D. ; Burden, A. C. ; Botha, J. L. ; Waugh, Norman Robert ; Morris, A. D. ; Gatling, W. ; Bingley, P. J. ; Patterson, C. C. / Mortality of South Asian patients with insulin-treated diabetes mellitus in the United Kingdom: a cohort study. In: Diabetic Medicine. 2004 ; Vol. 21, No. 8. pp. 845-855.
@article{da6d6d9fd625406f99899b6d9937efd3,
title = "Mortality of South Asian patients with insulin-treated diabetes mellitus in the United Kingdom: a cohort study",
abstract = "Aims To investigate mortality in South Asian patients with insulin-treated diabetes and compare it with mortality in non South Asian patients and in the general population.Methods A prospective cohort study was conducted of 828 South Asian and 27 962 non South Asian patients in the UK with insulin-treated diabetes diagnosed at ages under 50 years. The patients were followed for up to 28 years. Ethnicity was determined by analysis of names. Standardized mortality ratios (SMRs) were calculated, comparing mortality in the cohort with expectations from the mortality experience of the general population.Results SMRs were significantly raised in both groups of patients, particularly the South Asians, and especially in women and subjects with diabetes onset at a young age. The SMRs for South Asian patients diagnosed under age 30 years were 3.9 (95{\%} CI 2.0-6.9) in men and 10.1 (5.6-16.6) in women, and in the corresponding non South Asians were 2.7 (2.6-2.9) and 4.0 (3.6-4.3), respectively. The SMR in women was highly significantly greater in South Asians than non South Asians. The mortality in the young-onset patients was due to several causes, while that in the patients diagnosed at ages 30-49 was largely due to cardiovascular disease, which accounted for 70{\%} of deaths in South Asian males and 73{\%} in females.Conclusions South Asian patients with insulin-treated diabetes suffer an exceptionally high mortality. Clarification of the full reasons for this mortality are needed, as are measures to reduce levels of known cardiovascular disease risk factors in these patients.",
keywords = "cohort, insulin-treated diabetes mellitus, mortality, South Asians, CORONARY-HEART-DISEASE, RISK-FACTORS, CARDIOVASCULAR-DISEASE, MYOCARDIAL-INFARCTION, ETHNIC-DIFFERENCES, CLINICAL-FEATURES, EUROPEAN ORIGIN, PREVALENCE, LONDON, COMPLICATIONS",
author = "Swerdlow, {A. J.} and Laing, {S. P.} and {dos Santos Silva}, I. and Slater, {S. D.} and Burden, {A. C.} and Botha, {J. L.} and Waugh, {Norman Robert} and Morris, {A. D.} and W. Gatling and Bingley, {P. J.} and Patterson, {C. C.}",
year = "2004",
doi = "10.1111/j.1464-5491.2004.01253.x",
language = "English",
volume = "21",
pages = "845--855",
journal = "Diabetic Medicine",
issn = "0742-3071",
publisher = "Wiley",
number = "8",

}

TY - JOUR

T1 - Mortality of South Asian patients with insulin-treated diabetes mellitus in the United Kingdom: a cohort study

AU - Swerdlow, A. J.

AU - Laing, S. P.

AU - dos Santos Silva, I.

AU - Slater, S. D.

AU - Burden, A. C.

AU - Botha, J. L.

AU - Waugh, Norman Robert

AU - Morris, A. D.

AU - Gatling, W.

AU - Bingley, P. J.

AU - Patterson, C. C.

PY - 2004

Y1 - 2004

N2 - Aims To investigate mortality in South Asian patients with insulin-treated diabetes and compare it with mortality in non South Asian patients and in the general population.Methods A prospective cohort study was conducted of 828 South Asian and 27 962 non South Asian patients in the UK with insulin-treated diabetes diagnosed at ages under 50 years. The patients were followed for up to 28 years. Ethnicity was determined by analysis of names. Standardized mortality ratios (SMRs) were calculated, comparing mortality in the cohort with expectations from the mortality experience of the general population.Results SMRs were significantly raised in both groups of patients, particularly the South Asians, and especially in women and subjects with diabetes onset at a young age. The SMRs for South Asian patients diagnosed under age 30 years were 3.9 (95% CI 2.0-6.9) in men and 10.1 (5.6-16.6) in women, and in the corresponding non South Asians were 2.7 (2.6-2.9) and 4.0 (3.6-4.3), respectively. The SMR in women was highly significantly greater in South Asians than non South Asians. The mortality in the young-onset patients was due to several causes, while that in the patients diagnosed at ages 30-49 was largely due to cardiovascular disease, which accounted for 70% of deaths in South Asian males and 73% in females.Conclusions South Asian patients with insulin-treated diabetes suffer an exceptionally high mortality. Clarification of the full reasons for this mortality are needed, as are measures to reduce levels of known cardiovascular disease risk factors in these patients.

AB - Aims To investigate mortality in South Asian patients with insulin-treated diabetes and compare it with mortality in non South Asian patients and in the general population.Methods A prospective cohort study was conducted of 828 South Asian and 27 962 non South Asian patients in the UK with insulin-treated diabetes diagnosed at ages under 50 years. The patients were followed for up to 28 years. Ethnicity was determined by analysis of names. Standardized mortality ratios (SMRs) were calculated, comparing mortality in the cohort with expectations from the mortality experience of the general population.Results SMRs were significantly raised in both groups of patients, particularly the South Asians, and especially in women and subjects with diabetes onset at a young age. The SMRs for South Asian patients diagnosed under age 30 years were 3.9 (95% CI 2.0-6.9) in men and 10.1 (5.6-16.6) in women, and in the corresponding non South Asians were 2.7 (2.6-2.9) and 4.0 (3.6-4.3), respectively. The SMR in women was highly significantly greater in South Asians than non South Asians. The mortality in the young-onset patients was due to several causes, while that in the patients diagnosed at ages 30-49 was largely due to cardiovascular disease, which accounted for 70% of deaths in South Asian males and 73% in females.Conclusions South Asian patients with insulin-treated diabetes suffer an exceptionally high mortality. Clarification of the full reasons for this mortality are needed, as are measures to reduce levels of known cardiovascular disease risk factors in these patients.

KW - cohort

KW - insulin-treated diabetes mellitus

KW - mortality

KW - South Asians

KW - CORONARY-HEART-DISEASE

KW - RISK-FACTORS

KW - CARDIOVASCULAR-DISEASE

KW - MYOCARDIAL-INFARCTION

KW - ETHNIC-DIFFERENCES

KW - CLINICAL-FEATURES

KW - EUROPEAN ORIGIN

KW - PREVALENCE

KW - LONDON

KW - COMPLICATIONS

U2 - 10.1111/j.1464-5491.2004.01253.x

DO - 10.1111/j.1464-5491.2004.01253.x

M3 - Article

VL - 21

SP - 845

EP - 855

JO - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

IS - 8

ER -