Introduction Cardiovascular disease (CVD) mortality in people with diabetes is decreasing. However, few studies have examined this at a national level. The aim of this study was to examine mortality trends, by age-group, in over one million Australians with diabetes.
Methods The study included 1,136,617 (7.6% type 1) people with diabetes registered on the National Diabetes Service Scheme between 2000 and 2010. Vital status and cause of death were collected by linkage to the National Death Index. Cause-specific deaths were coded according to International Classification of Disease coding. Rates were standardised to the 2001 Australian population. Analyses were stratified by diabetes type and by age-group.
Results Age-standardised all-cause mortality rates (per 1000 person-years) fell from 17.7 in 2000 to 14.1 in 2010 for type 1 diabetes, and from 9.9 to 8.2 for type 2. CVD mortality decreased from 5.9 in 2000 to 2.8 in 2010 for type 1, and from 2.9 to 1.3 for type 2. Cancer mortality increased from 1.1 to 1.5 for type 1, and from 2.3 to 2.4 for type 2. Declines in all-cause mortality were seen across all age-groups while in CVD, mortality appeared to be stable in 20-40 and 40-60, but significantly declined in individuals aged 60+. For cancer mortality in type 1 diabetes, increases in mortality rates were observed in those aged 60+, while rates in younger age-groups were stable over time. For type 2 diabetes, cancer mortality rates increased in the 20-40 and 60+ age-groups, but decreased in the 40-60s. All changes reported were statistically significant.
Conclusions All-cause and CVD mortality rates in type 1 and type 2 diabetes have decreased, but have been partially offset by increased cancer mortality rates. Clinicians should be vigilant in adhering to current cancer screening guidelines as early detection will be key to preventing premature mortality.