We’ve been hearing about the “diabetes epidemic” for a long time. Some have even said it might be the biggest epidemic in human history. Most of the cases are type 2 diabetes, but not all. In 2020, the U.S. Centers for Disease Control and Prevention (CDC) issued a report showing a nearly 30% increase in type 1 diabetes diagnoses in the United States, with cases among the young growing most sharply.
When it comes to type 1 diabetes, however, a new study conducted in six countries brings a bit of good news. According to the report, although more people might be getting type 1 diabetes, fewer are dying from it. Mortality rates in people with type 1 diabetes have declined from 2000 to 2016.
The research team, which was led by scientists at the Baker Heart and Diabetes Institute in Melbourne, Australia, said that some previous studies had already noted a decrease in mortality among people with type 1 diabetes, but these reports concentrated on children and young adults. Their study, however, examined trends in people ages 0 to 79. Using data obtained from administrative sources, databases, health insurance records, and health registries, they studied populations in six countries: Australia, Denmark, Latvia, Scotland, Spain (the Catalonia region), and the United States, where the data was obtained from Kaiser Permanente Northwest. They identified death from all causes in people with type 1 diabetes and compared the diabetes population to the non-diabetes population. They also determined what’s known as the standardized mortality ratio (SMR). This statistic compares the increase or decrease in the number of deaths observed in a specific population (in this case people with type 1 diabetes) to the general population.
To get cutting-edge diabetes news, strategies for blood glucose management, nutrition tips, healthy recipes, and more delivered straight to your inbox, sign up for our free newsletters!
Decline in mortality rates among people with type 1 diabetes
During the study period the researchers identified 18,105 deaths among people with type 1 diabetes (11,355 in men and 6,750 in women). The mortality rate was slightly higher in men than in women, but all told the study authors reported,
“All-cause mortality rates in people with type 1 diabetes declined in most studied populations and across a wide range of ages from 2000 to 2016.” Also, they said, “The standardised mortality ratio, reflecting excess mortality in people with type 1 diabetes relative to those without diabetes, declined over time in half of the six data sources included.” Although this was very good news, they also noted that “people with type 1 diabetes still had a two to five times higher risk of death compared with those without diabetes.”
The decline in all-cause mortality rates varied among the countries surveyed. In Australia, the decline was 2.1%. In Denmark it was 5.8%; Scotland, 4.6%; Spain, 3.8%; and the United States, 3.4%. In Latvia the drop was 2.2%, but the decline leveled off after 2008 and the mortality remained relatively stable from approximately 2009 to 2016. As for SMRs, Denmark, Scotland, and Spain showed declines over the study period, which, the authors explained, indicated “larger declines in all-cause mortality rates among people with type 1 diabetes compared with those without diabetes.” SMRs were stable in the other three countries. Finally, the rate at which mortality was declining was similar for men and for women and across different age groups.
The authors attributed the decline in mortality to “advances in treatment and interventions for type 1 diabetes, as well as the improvement in cardiovascular disease prevention with widespread use of statins and antihypertensive medications over the last two decades.” According to study co-author Jonathan Shaw, MD, “There is still a great deal more to understand about type 1 diabetes and we are committed to understand what is driving the increasing cases globally. But at least when it comes to death rates, there is some good news.” Justine Cain, CEO of the organization Diabetes Australia, noted, “These findings are extremely heartening for people living with type 1 diabetes and their families and loved ones.”