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Mortality in childhood-onset type 1 diabetes mellitus with onset between 1959 and 1996: A population-based study in Hokkaido, Japan

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Abstract

Aim

To examine the mortality rate and causes of death in childhood-onset type 1 diabetes in Japan.

Methods

For a median 36.7 years, we followed 391 patients under the age of 15 years who developed type 1 diabetes between 1959 and 1996. We calculated the mortality rate per 100,000 person-years and the standardised mortality ratio (SMR) according to risk factors.

Results

The mortality rates and SMRs were 823 and 8.8 with onset during 1959—1979, 370 and 5.9 with onset during 1980—1989, and 133 and 3.2 with onset during 1990—1996, respectively. The mortality rates and SMRs were 359 and 8.4 in men, and 235 and 6.0 in women. Mortality rates and SMRs were 452 and 7.3 in patients with diabetes onset before puberty and 514 and 6.3 in patients with onset after puberty. The main causes of death with shorter disease duration were sudden death, accident/suicide, and acute diabetic complications. With a more than 30-year disease duration, the main causes of death were end-stage renal disease and cardiovascular disease.

Conclusions

This cohort study revealed a decrease in the mortality rate between 1959—1979 and 1990—1996 in patients with childhood-onset type 1 diabetes in Japan. Patients with onset after puberty had a higher mortality rate than those with onset before puberty.

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Data availability

The data that support the findings of this study are not publicly available because they contain sensitive information; however, these are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank the study participants, attending physicians, and investigators. The authors also thank the members of the DERI group, especially Drs Naoko Tajima, Rimei Nishimura, Aya Morimoto, and Yoshiko Onda for statistical suggestions for the research. Finally, we thank Anahid Pinchis and Analisa Avila, MPH, ELS, of Edanz for editing a draft of this manuscript. This work was supported by the Ministry of Education, Culture, Sports, Science and Technology of Japan (21K10442) and by the Costco Japan Research Aid Fund (no grant number).

Funding

Ministry of Education, Culture, Sports, Science and Technology of Japan, 21K10442, Hiroshi Yokomichi; Costco Japan Research Aid Fund, no grant number, Nobuo Matsuura.

Author information

Authors and Affiliations

  1. Department of Reproductive and Developmental Medicine, Graduate School of Medicine, Hokkaido University, 7 Nishi, 15 Kita, Kita-ku, City of Sapporo, Hokkaido, Japan

    Nobuo Matsuura

  2. Department of Epidemiology and Environmental Medicine, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan

    Hiroshi Yokomichi

  3. Division of Clinical Medicine, Japanese Red Cross Hokkaido College of Nursing, 664-1 Akebono, Kitami City, Hokkaido, Japan

    Yoshiya Ito

  4. Department of Paediatrics, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa City, Hokkaido, Japan

    Shigeru Suzuki

  5. Department of Paediatrics, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan

    Mie Mochizuki

  6. Department of Paediatrics, NHO Kofu National Hospital, 11-35 Tenjin, Kofu City, Yamanashi, Japan

    Mie Mochizuki

Authors
  1. Nobuo Matsuura
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  2. Hiroshi Yokomichi
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  3. Yoshiya Ito
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  4. Shigeru Suzuki
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  5. Mie Mochizuki
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Consortia

on behalf of the Study Group of Long-term Prognosis of Type 1 Diabetes in Hokkaido, Japan

Contributions

NM created the study concept and design, wrote the first draft, and obtained funding. YI, SS, and MM followed up with the patients and acquired the study data. HY analysed the data, performed the statistical analysis, wrote the first draft, and obtained funding.

Corresponding author

Correspondence to Hiroshi Yokomichi.

Ethics declarations

Conflict of interest

Matsuura N., Yokomichi H., Ito Y., Suzuki S., and Mochizuki M. declare that they have no conflicts of interest.

Ethical approval

The protocol for this study was approved by the ethics committee of Hokkaido University (approval number: 019–0256). The follow-up survey was started after the approval of the ethics committee on 10 January 2020 and ended in March 2022.

Human or animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and/or with the Helsinki Declaration of 1964 and later versions. Informed consent or substitute for it was obtained from all patients for being included in the study.

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Matsuura, N., Yokomichi, H., Ito, Y. et al. Mortality in childhood-onset type 1 diabetes mellitus with onset between 1959 and 1996: A population-based study in Hokkaido, Japan. Diabetol Int 15, 262–269 (2024). https://doi.org/10.1007/s13340-023-00688-0

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  • DOI: https://doi.org/10.1007/s13340-023-00688-0

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