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Research article:
Life Expectancy and Cause-Specific Mortality in Type 2 Diabetes: A Population-Based Cohort Study Quantifying Relationships in Ethnic Subgroups
Reference:
Alison K. Wright, Evangelos Kontopantelis, Richard Emsley, Iain Buchan, Naveed Sattar, Martin K. Rutter, Darren M. Ashcroft(2017) Life Expectancy and Cause-Specific Mortality in Type 2 Diabetes: A Population-Based Cohort Study Quantifying Relationships in Ethnic Subgroups. Diabetes Care, doi: 10.2337/dc16-1616
- Link to article
- Abstract
- OBJECTIVES This study 1) investigated life expectancy and cause-specific mortality rates associated with type 2 diabetes and 2) quantified these relationships in ethnic subgroups. RESEARCH DESIGN AND METHODS This was a cohort study using Clinical Practice Research Datalink data from 383 general practices in England with linked hospitalization and mortality records. A total of 187,968 patients with incident type 2 diabetes from 1998 to 2015 were matched to 908,016 control subjects. Abridged life tables estimated years of life lost, and a competing risk survival model quantified cause-specific hazard ratios (HRs). RESULTS A total of 40,286 deaths occurred in patients with type 2 diabetes. At age 40, white men with diabetes lost 5 years of life and white women lost 6 years compared with those without diabetes. A loss of between 1 and 2 years was observed for South Asians and blacks with diabetes. At age older than 65 years, South Asians with diabetes had up to 1.1 years’ longer life expectancy than South Asians without diabetes. Compared with whites with diabetes, South Asians with diabetes had lower adjusted risks for mortality from cardiovascular (HR 0.82; 95% CI 0.75, 0.89), cancer (HR 0.43; 95% CI 0.36, 0.51), and respiratory diseases (HR 0.60; 95% CI 0.48, 0.76). A similar pattern was observed in blacks with diabetes compared with whites with diabetes. CONCLUSIONS Type 2 diabetes was associated with more years of life lost among whites than among South Asians or blacks, with older South Asians experiencing longer life expectancy compared with South Asians without diabetes. The findings support optimized cardiovascular disease risk factor management, especially in whites with type 2 diabetes.
- Author for correspondence
- Darren M. Ashcroft
- Email for correspondence
- darren.ashcroft@manchester.ac.uk.
Code list: res56: Cardiovascular Disease
190 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| G3...00 | Read | Ischaemic heart disease | diagnostic | res56: Cardiovascular Disease | |||
| G30..00 | Read | Acute myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G300.00 | Read | Acute anterolateral infarction | diagnostic | res56: Cardiovascular Disease | |||
| G301.00 | Read | Other specified anterior myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G301000 | Read | Acute anteroapical infarction | diagnostic | res56: Cardiovascular Disease | |||
| G301100 | Read | Acute anteroseptal infarction | diagnostic | res56: Cardiovascular Disease | |||
| G30..12 | Read | Coronary thrombosis | diagnostic | res56: Cardiovascular Disease | |||
| G30..13 | Read | Cardiac rupture following myocardial infarction (MI) | diagnostic | res56: Cardiovascular Disease | |||
| G30..15 | Read | MI - acute myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G30..16 | Read | Thrombosis - coronary | diagnostic | res56: Cardiovascular Disease | |||
| G30..17 | Read | Silent myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G301z00 | Read | Anterior myocardial infarction NOS | diagnostic | res56: Cardiovascular Disease | |||
| G302.00 | Read | Acute inferolateral infarction | diagnostic | res56: Cardiovascular Disease | |||
| G303.00 | Read | Acute inferoposterior infarction | diagnostic | res56: Cardiovascular Disease | |||
| G304.00 | Read | Posterior myocardial infarction NOS | diagnostic | res56: Cardiovascular Disease | |||
| G305.00 | Read | Lateral myocardial infarction NOS | diagnostic | res56: Cardiovascular Disease | |||
| G306.00 | Read | True posterior myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G307.00 | Read | Acute subendocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G307000 | Read | Acute non-Q wave infarction | diagnostic | res56: Cardiovascular Disease | |||
| G307100 | Read | Acute non-ST segment elevation myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G308.00 | Read | Inferior myocardial infarction NOS | diagnostic | res56: Cardiovascular Disease | |||
| G309.00 | Read | Acute Q-wave infarct | diagnostic | res56: Cardiovascular Disease | |||
| G30B.00 | Read | Acute posterolateral myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G30X.00 | Read | Acute transmural myocardial infarction of unspecif site | diagnostic | res56: Cardiovascular Disease | |||
| G30X000 | Read | Acute ST segment elevation myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G30y.00 | Read | Other acute myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G30y100 | Read | Acute papillary muscle infarction | diagnostic | res56: Cardiovascular Disease | |||
| G30y200 | Read | Acute septal infarction | diagnostic | res56: Cardiovascular Disease | |||
| G30yz00 | Read | Other acute myocardial infarction NOS | diagnostic | res56: Cardiovascular Disease | |||
| G30z.00 | Read | Acute myocardial infarction NOS | diagnostic | res56: Cardiovascular Disease | |||
| G31..00 | Read | Other acute and subacute ischaemic heart disease | diagnostic | res56: Cardiovascular Disease | |||
| G310.00 | Read | Postmyocardial infarction syndrome | diagnostic | res56: Cardiovascular Disease | |||
| G310.11 | Read | Dressler's syndrome | diagnostic | res56: Cardiovascular Disease | |||
| G3...11 | Read | Arteriosclerotic heart disease | diagnostic | res56: Cardiovascular Disease | |||
| G311.00 | Read | Preinfarction syndrome | diagnostic | res56: Cardiovascular Disease | |||
| G311000 | Read | Myocardial infarction aborted | diagnostic | res56: Cardiovascular Disease | |||
| G311011 | Read | MI - myocardial infarction aborted | diagnostic | res56: Cardiovascular Disease | |||
| G311100 | Read | Unstable angina | diagnostic | res56: Cardiovascular Disease | |||
| G311.11 | Read | Crescendo angina | diagnostic | res56: Cardiovascular Disease | |||
| G311.12 | Read | Impending infarction | diagnostic | res56: Cardiovascular Disease | |||
| G311.13 | Read | Unstable angina | diagnostic | res56: Cardiovascular Disease | |||
| G311.14 | Read | Angina at rest | diagnostic | res56: Cardiovascular Disease | |||
| G311200 | Read | Angina at rest | diagnostic | res56: Cardiovascular Disease | |||
| G311300 | Read | Refractory angina | diagnostic | res56: Cardiovascular Disease | |||
| G311500 | Read | Acute coronary syndrome | diagnostic | res56: Cardiovascular Disease | |||
| G311z00 | Read | Preinfarction syndrome NOS | diagnostic | res56: Cardiovascular Disease | |||
| G3...12 | Read | Atherosclerotic heart disease | diagnostic | res56: Cardiovascular Disease | |||
| G3...13 | Read | IHD - Ischaemic heart disease | diagnostic | res56: Cardiovascular Disease | |||
| G31y.00 | Read | Other acute and subacute ischaemic heart disease | diagnostic | res56: Cardiovascular Disease | |||
| G31y000 | Read | Acute coronary insufficiency | diagnostic | res56: Cardiovascular Disease | |||
| G31y200 | Read | Subendocardial ischaemia | diagnostic | res56: Cardiovascular Disease | |||
| G31y300 | Read | Transient myocardial ischaemia | diagnostic | res56: Cardiovascular Disease | |||
| G31yz00 | Read | Other acute and subacute ischaemic heart disease NOS | diagnostic | res56: Cardiovascular Disease | |||
| G32..00 | Read | Old myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G32..11 | Read | Healed myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G32..12 | Read | Personal history of myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G33..00 | Read | Angina pectoris | diagnostic | res56: Cardiovascular Disease | |||
| G330.00 | Read | Angina decubitus | diagnostic | res56: Cardiovascular Disease | |||
| G330000 | Read | Nocturnal angina | diagnostic | res56: Cardiovascular Disease | |||
| G330z00 | Read | Angina decubitus NOS | diagnostic | res56: Cardiovascular Disease | |||
| G331.00 | Read | Prinzmetal's angina | diagnostic | res56: Cardiovascular Disease | |||
| G331.11 | Read | Variant angina pectoris | diagnostic | res56: Cardiovascular Disease | |||
| G332.00 | Read | Coronary artery spasm | diagnostic | res56: Cardiovascular Disease | |||
| G33z.00 | Read | Angina pectoris NOS | diagnostic | res56: Cardiovascular Disease | |||
| G33z000 | Read | Status anginosus | diagnostic | res56: Cardiovascular Disease | |||
| G33z100 | Read | Stenocardia | diagnostic | res56: Cardiovascular Disease | |||
| G33z200 | Read | Syncope anginosa | diagnostic | res56: Cardiovascular Disease | |||
| G33z300 | Read | Angina on effort | diagnostic | res56: Cardiovascular Disease | |||
| G33z400 | Read | Ischaemic chest pain | diagnostic | res56: Cardiovascular Disease | |||
| G33z500 | Read | Post infarct angina | diagnostic | res56: Cardiovascular Disease | |||
| G33z600 | Read | New onset angina | diagnostic | res56: Cardiovascular Disease | |||
| G33z700 | Read | Stable angina | diagnostic | res56: Cardiovascular Disease | |||
| G33zz00 | Read | Angina pectoris NOS | diagnostic | res56: Cardiovascular Disease | |||
| G34..00 | Read | Other chronic ischaemic heart disease | diagnostic | res56: Cardiovascular Disease | |||
| G340.00 | Read | Coronary atherosclerosis | diagnostic | res56: Cardiovascular Disease | |||
| G340000 | Read | Single coronary vessel disease | diagnostic | res56: Cardiovascular Disease | |||
| G340100 | Read | Double coronary vessel disease | diagnostic | res56: Cardiovascular Disease | |||
| G340.11 | Read | Triple vessel disease of the heart | diagnostic | res56: Cardiovascular Disease | |||
| G340.12 | Read | Coronary artery disease | diagnostic | res56: Cardiovascular Disease | |||
| G342.00 | Read | Atherosclerotic cardiovascular disease | diagnostic | res56: Cardiovascular Disease | |||
| G343.00 | Read | Ischaemic cardiomyopathy | diagnostic | res56: Cardiovascular Disease | |||
| G344.00 | Read | Silent myocardial ischaemia | diagnostic | res56: Cardiovascular Disease | |||
| G34y.00 | Read | Other specified chronic ischaemic heart disease | diagnostic | res56: Cardiovascular Disease | |||
| G34y000 | Read | Chronic coronary insufficiency | diagnostic | res56: Cardiovascular Disease | |||
| G34y100 | Read | Chronic myocardial ischaemia | diagnostic | res56: Cardiovascular Disease | |||
| G34yz00 | Read | Other specified chronic ischaemic heart disease NOS | diagnostic | res56: Cardiovascular Disease | |||
| G34z.00 | Read | Other chronic ischaemic heart disease NOS | diagnostic | res56: Cardiovascular Disease | |||
| G34z000 | Read | Asymptomatic coronary heart disease | diagnostic | res56: Cardiovascular Disease | |||
| G35..00 | Read | Subsequent myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G350.00 | Read | Subsequent myocardial infarction of anterior wall | diagnostic | res56: Cardiovascular Disease | |||
| G351.00 | Read | Subsequent myocardial infarction of inferior wall | diagnostic | res56: Cardiovascular Disease | |||
| G353.00 | Read | Subsequent myocardial infarction of other sites | diagnostic | res56: Cardiovascular Disease | |||
| G35X.00 | Read | Subsequent myocardial infarction of unspecified site | diagnostic | res56: Cardiovascular Disease | |||
| G360.00 | Read | Haemopericardium/current comp folow acut myocard infarct | diagnostic | res56: Cardiovascular Disease | |||
| G362.00 | Read | Ventric septal defect/curr comp fol acut myocardal infarctn | diagnostic | res56: Cardiovascular Disease | |||
| G363.00 | Read | Ruptur cardiac wall w'out haemopericard/cur comp fol ac MI | diagnostic | res56: Cardiovascular Disease | |||
| G364.00 | Read | Ruptur chordae tendinae/curr comp fol acute myocard infarct | diagnostic | res56: Cardiovascular Disease | |||
| G365.00 | Read | Rupture papillary muscle/curr comp fol acute myocard infarct | diagnostic | res56: Cardiovascular Disease | |||
| G38..00 | Read | Postoperative myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G380.00 | Read | Postoperative transmural myocardial infarction anterior wall | diagnostic | res56: Cardiovascular Disease | |||
| G381.00 | Read | Postoperative transmural myocardial infarction inferior wall | diagnostic | res56: Cardiovascular Disease | |||
| G384.00 | Read | Postoperative subendocardial myocardial infarction | diagnostic | res56: Cardiovascular Disease | |||
| G38z.00 | Read | Postoperative myocardial infarction, unspecified | diagnostic | res56: Cardiovascular Disease | |||
| G3y..00 | Read | Other specified ischaemic heart disease | diagnostic | res56: Cardiovascular Disease | |||
| G3z..00 | Read | Ischaemic heart disease NOS | diagnostic | res56: Cardiovascular Disease | |||
| G574011 | Read | Cardiac arrest-ventricular fibrillation | diagnostic | res56: Cardiovascular Disease | |||
| G575.00 | Read | Cardiac arrest | diagnostic | res56: Cardiovascular Disease | |||
| G575000 | Read | Cardiac arrest with successful resuscitation | diagnostic | res56: Cardiovascular Disease | |||
| G575100 | Read | Sudden cardiac death, so described | diagnostic | res56: Cardiovascular Disease | |||
| G575.11 | Read | Cardio-respiratory arrest | diagnostic | res56: Cardiovascular Disease | |||
| G575.12 | Read | Asystole | diagnostic | res56: Cardiovascular Disease | |||
| G575z00 | Read | Cardiac arrest, unspecified | diagnostic | res56: Cardiovascular Disease | |||
| G61..00 | Read | Intracerebral haemorrhage | diagnostic | res56: Cardiovascular Disease | |||
| G610.00 | Read | Cortical haemorrhage | diagnostic | res56: Cardiovascular Disease | |||
| G611.00 | Read | Internal capsule haemorrhage | diagnostic | res56: Cardiovascular Disease | |||
| G61..11 | Read | CVA - cerebrovascular accid due to intracerebral haemorrhage | diagnostic | res56: Cardiovascular Disease | |||
| G61..12 | Read | Stroke due to intracerebral haemorrhage | diagnostic | res56: Cardiovascular Disease | |||
| G612.00 | Read | Basal nucleus haemorrhage | diagnostic | res56: Cardiovascular Disease | |||
| G613.00 | Read | Cerebellar haemorrhage | diagnostic | res56: Cardiovascular Disease | |||
| G614.00 | Read | Pontine haemorrhage | diagnostic | res56: Cardiovascular Disease | |||
| G615.00 | Read | Bulbar haemorrhage | diagnostic | res56: Cardiovascular Disease | |||
| G616.00 | Read | External capsule haemorrhage | diagnostic | res56: Cardiovascular Disease | |||
| G617.00 | Read | Intracerebral haemorrhage, intraventricular | diagnostic | res56: Cardiovascular Disease | |||
| G618.00 | Read | Intracerebral haemorrhage, multiple localized | diagnostic | res56: Cardiovascular Disease | |||
| G61X.00 | Read | Intracerebral haemorrhage in hemisphere, unspecified | diagnostic | res56: Cardiovascular Disease | |||
| G61X000 | Read | Left sided intracerebral haemorrhage, unspecified | diagnostic | res56: Cardiovascular Disease | |||
| G61X100 | Read | Right sided intracerebral haemorrhage, unspecified | diagnostic | res56: Cardiovascular Disease | |||
| G61z.00 | Read | Intracerebral haemorrhage NOS | diagnostic | res56: Cardiovascular Disease | |||
| G63..00 | Read | Precerebral arterial occlusion | diagnostic | res56: Cardiovascular Disease | |||
| G63..11 | Read | Infarction - precerebral | diagnostic | res56: Cardiovascular Disease | |||
| G632.00 | Read | Vertebral artery occlusion | diagnostic | res56: Cardiovascular Disease | |||
| G63y000 | Read | Cerebral infarct due to thrombosis of precerebral arteries | diagnostic | res56: Cardiovascular Disease | |||
| G63y100 | Read | Cerebral infarction due to embolism of precerebral arteries | diagnostic | res56: Cardiovascular Disease | |||
| G640.00 | Read | Cerebral thrombosis | diagnostic | res56: Cardiovascular Disease | |||
| G640000 | Read | Cerebral infarction due to thrombosis of cerebral arteries | diagnostic | res56: Cardiovascular Disease | |||
| G641.00 | Read | Cerebral embolism | diagnostic | res56: Cardiovascular Disease | |||
| G641000 | Read | Cerebral infarction due to embolism of cerebral arteries | diagnostic | res56: Cardiovascular Disease | |||
| G641.11 | Read | Cerebral embolus | diagnostic | res56: Cardiovascular Disease | |||
| G64..12 | Read | Infarction - cerebral | diagnostic | res56: Cardiovascular Disease | |||
| G64..13 | Read | Stroke due to cerebral arterial occlusion | diagnostic | res56: Cardiovascular Disease | |||
| G64z.00 | Read | Cerebral infarction NOS | diagnostic | res56: Cardiovascular Disease | |||
| G64z000 | Read | Brainstem infarction | diagnostic | res56: Cardiovascular Disease | |||
| G64z.11 | Read | Brainstem infarction NOS | diagnostic | res56: Cardiovascular Disease | |||
| G64z111 | Read | Lateral medullary syndrome | diagnostic | res56: Cardiovascular Disease | |||
| G64z.12 | Read | Cerebellar infarction | diagnostic | res56: Cardiovascular Disease | |||
| G64z200 | Read | Left sided cerebral infarction | diagnostic | res56: Cardiovascular Disease | |||
| G64z300 | Read | Right sided cerebral infarction | diagnostic | res56: Cardiovascular Disease | |||
| G64z400 | Read | Infarction of basal ganglia | diagnostic | res56: Cardiovascular Disease | |||
| G66..00 | Read | Stroke and cerebrovascular accident unspecified | diagnostic | res56: Cardiovascular Disease | |||
| G661.00 | Read | Anterior cerebral artery syndrome | diagnostic | res56: Cardiovascular Disease | |||
| G66..11 | Read | CVA unspecified | diagnostic | res56: Cardiovascular Disease | |||
| G66..12 | Read | Stroke unspecified | diagnostic | res56: Cardiovascular Disease | |||
| G66..13 | Read | CVA - Cerebrovascular accident unspecified | diagnostic | res56: Cardiovascular Disease | |||
| G662.00 | Read | Posterior cerebral artery syndrome | diagnostic | res56: Cardiovascular Disease | |||
| G663.00 | Read | Brain stem stroke syndrome | diagnostic | res56: Cardiovascular Disease | |||
| G664.00 | Read | Cerebellar stroke syndrome | diagnostic | res56: Cardiovascular Disease | |||
| G665.00 | Read | Pure motor lacunar syndrome | diagnostic | res56: Cardiovascular Disease | |||
| G666.00 | Read | Pure sensory lacunar syndrome | diagnostic | res56: Cardiovascular Disease | |||
| G667.00 | Read | Left sided CVA | diagnostic | res56: Cardiovascular Disease | |||
| G668.00 | Read | Right sided CVA | diagnostic | res56: Cardiovascular Disease | |||
| G671.00 | Read | Generalised ischaemic cerebrovascular disease NOS | diagnostic | res56: Cardiovascular Disease | |||
| G671000 | Read | Acute cerebrovascular insufficiency NOS | diagnostic | res56: Cardiovascular Disease | |||
| G671z00 | Read | Generalised ischaemic cerebrovascular disease NOS | diagnostic | res56: Cardiovascular Disease | |||
| G676000 | Read | Cereb infarct due cerebral venous thrombosis, nonpyogenic | diagnostic | res56: Cardiovascular Disease | |||
| G6W..00 | Read | Cereb infarct due unsp occlus/stenos precerebr arteries | diagnostic | res56: Cardiovascular Disease | |||
| G6X..00 | Read | Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs | diagnostic | res56: Cardiovascular Disease | |||
| G70..00 | Read | Atherosclerosis | diagnostic | res56: Cardiovascular Disease | |||
| G700.00 | Read | Aortic atherosclerosis | diagnostic | res56: Cardiovascular Disease | |||
| G73..00 | Read | Other peripheral vascular disease | diagnostic | res56: Cardiovascular Disease | |||
| G73..12 | Read | Ischaemia of legs | diagnostic | res56: Cardiovascular Disease | |||
| G73y.00 | Read | Other specified peripheral vascular disease | diagnostic | res56: Cardiovascular Disease | |||
| G73yz00 | Read | Other specified peripheral vascular disease NOS | diagnostic | res56: Cardiovascular Disease | |||
| G73z.00 | Read | Peripheral vascular disease NOS | diagnostic | res56: Cardiovascular Disease | |||
| G73z000 | Read | Intermittent claudication | diagnostic | res56: Cardiovascular Disease | |||
| G73z011 | Read | Claudication | diagnostic | res56: Cardiovascular Disease | |||
| G73zz00 | Read | Peripheral vascular disease NOS | diagnostic | res56: Cardiovascular Disease | |||
| G742z00 | Read | Peripheral arterial embolism and thrombosis NOS | diagnostic | res56: Cardiovascular Disease | |||
| G74y300 | Read | Embolism and thrombosis of the iliac artery unspecified | diagnostic | res56: Cardiovascular Disease | |||
| G76z000 | Read | Iliac artery occlusion | diagnostic | res56: Cardiovascular Disease | |||
| Gyu3.00 | Read | [X]Ischaemic heart diseases | diagnostic | res56: Cardiovascular Disease | |||
| Gyu3200 | Read | [X]Other forms of acute ischaemic heart disease | diagnostic | res56: Cardiovascular Disease | |||
| Gyu3300 | Read | [X]Other forms of chronic ischaemic heart disease | diagnostic | res56: Cardiovascular Disease | |||
| Gyu3400 | Read | [X]Acute transmural myocardial infarction of unspecif site | diagnostic | res56: Cardiovascular Disease | |||
| Gyu3600 | Read | [X]Subsequent myocardial infarction of unspecified site | diagnostic | res56: Cardiovascular Disease | |||
| Gyu6200 | Read | [X]Other intracerebral haemorrhage | diagnostic | res56: Cardiovascular Disease | |||
| Gyu6300 | Read | [X]Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs | diagnostic | res56: Cardiovascular Disease | |||
| Gyu6400 | Read | [X]Other cerebral infarction | diagnostic | res56: Cardiovascular Disease | |||
| Gyu6F00 | Read | [X]Intracerebral haemorrhage in hemisphere, unspecified | diagnostic | res56: Cardiovascular Disease | |||
| Gyu6G00 | Read | [X]Cereb infarct due unsp occlus/stenos precerebr arteries | diagnostic | res56: Cardiovascular Disease | |||
| Gyu7400 | Read | [X]Other specified peripheral vascular diseases | diagnostic | res56: Cardiovascular Disease |
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