Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Mortality in Aboriginals vs Anglo Celts with type 2 diabetes: The Fremantle Diabetes Study Phase II (#380)

Jacequeline Hall 1 , Erin Latkovic 1 , Daniel McAullay 2 3 , Wendy A Davis 1 , Timothy M Davis 1
  1. The University of Western Australia, Fremantle, WA, Australia
  2. Kurongkurl Katitjin Centre for Indigenous Australian Education and Research, Edith Cowan University, Mt Lawley, Western Australia, Australia
  3. Australian Primary Health Care Research Institute, Australian National University, Canberra, Australian Capital Territory, Australia

Background and Aim: Since few contemporary studies have assessed prognosis in Aboriginals with type 2 diabetes (T2DM), we investigated the risk of all-cause mortality in community-based Aboriginals vs Anglo-Celts with T2DM.

Patients and Methods: The longitudinal Fremantle Diabetes Study Phase II includes 105 Aboriginal and 787 Anglo-Celt subjects with T2DM recruited between 2008 and 2011. This cohort was followed to death/census at end-March 2014. , a mean follow up of 4.3±1.2 (range 0.2-6.1) years.

Results: At baseline, the 892 patients had a mean±SD age of 65.7±11.5 years, 49% were male, and their median [inter-quartile range] diabetes duration was 8.0 [2.3-15.0] years. During follow-up, a similar proportion of Aboriginals and Anglo-Celts died (13.3% vs 10.4%, P=0.40). However, the age at death for Aboriginals was younger than for Anglo-Celts (59.1±14.0 vs 78.7±9.6 years, P<0.001). Cox proportional hazards modelling with age as the time-line showed that all-cause mortality was predicted by male sex (hazard ratio (95% CI): 2.46 (1.57-3.88)), current smoking (3.89 (2.22-6.81)), eGFR <45 ml/min/1.73m2 (2.07 (1.36-3.15)), whilst being married/in a de facto relationship was protective (0.53 (0.34-0.83)). After adjusting for this most parsimonious model, Aboriginals were 6 times more likely to have died than Anglo-Celts (6.05 (3.12-11.73)).

Conclusions: These Australian urban community-based data show that Aboriginals have substantially increased mortality, losing an average of 20 years of life vs Anglo-Celts. Multivariate analyses suggest that this situation could be improved by targeting smoking cessation and renoprotection.