Reviews in Endocrine and Metabolic Disorders

, Volume 17, Issue 1, pp 129–137 | Cite as

Determinants of mortality in patients with type 2 diabetes: a review

  • Jana Engelmann
  • Ulf Manuwald
  • Constanze Rubach
  • Joachim Kugler
  • Andreas L. Birkenfeld
  • Markolf Hanefeld
  • Ulrike RotheEmail author


We aimed to review and summarize the evidence from accomplished trials analyzing factors influencing mortality in patients with T2DM and to provide some recommendations for targets and treatment in the European region. The following databases were searched for relevant trials: PubMed and the Cochrane Library. Of 3.806 citations, 134 trials met our inclusion criteria. Results: The reduction in lifetime for 65 + −years-old patients having less than 10 years T2DM amounts to 1.8 years. Having T2DM for more than 10 years lifetime will be reduced by 2.7 years. However, the lifetime shortening factor of T2DM will even be stronger for 40 + −years-old patients at onset. Males will lose 11.6 years of life and 18.6 QUALYs. T2DM among females will reduce life by 14 QUALYs by 22 years. From a statistical point of view, the highest mortality rate will occur in an over 55-years-old European smoking and non-compliant diabetic woman with alcohol abuse living in a rural area with a low level of education and a low socio-economic status. Furthermore, other co-morbidities such as cardiovascular diseases, gout, and depression affect mortality. Additionally, mortality will increase with a BMI over 35 and also with a BMI under 20–25. This refers to the obesity paradox indicating a higher mortality rate among normal weight patients with T2DM compared to overweight patients with T2DM. HbA1c-levels between 6.5 % and 7 % are associated with the lowest impact on mortality.


Determinants Mortality T2DM Survival Lifetime Life expectancy 


Compliance with ethical standards

Conflict of Interest

All authors have declared that they have no conflicts related to this work.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Jana Engelmann
    • 1
  • Ulf Manuwald
    • 1
  • Constanze Rubach
    • 1
  • Joachim Kugler
    • 1
  • Andreas L. Birkenfeld
    • 2
    • 3
  • Markolf Hanefeld
    • 3
  • Ulrike Rothe
    • 1
    Email author
  1. 1.Health Sciences/Public Health, Faculty of MedicineTUDDresdenGermany
  2. 2.Medical Clinic III, University Clinic, Faculty of MedicineTUDDresdenGermany
  3. 3.Study Center Prof. Hanefeld, Research for Metabolic Vascular SyndromeGWT-TUD GmbHDresdenGermany

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