Higher Risk of Noncardiovascular Death in a Population-Based Cohort of Type 1 Diabetes

Introduction and Objective: Mortality in individuals with type 1 diabetes (T1D) is higher compared to the general population. This study aims to describe all-cause mortality in a US population-based cohort of people with T1D from 1935 to 2017 Methods: T1D diagnoses were identified using the Rochester Epidemiology Project database, with confirmation through chart review (Table 1). Mortality data from death certificates and autopsy results were collected. Standardized mortality ratios (SMR), Kaplan-Meier survival estimates, and Cox regression were used for analysis. The underlying cause of death was clinically verified and confirmed by autopsy Results: There were 209 deaths in 1,178 individuals, with a mean T1D duration of 32 years (SD 20.4) (Table 1). The overall SMR was 3.12 (95% CI 2.70-3.54). Cause specific mortality rate per 100,00 patient years due to acute diabetes complications (DKA, hypoglycemia) was higher in men (Table 2, 1038.5 vs 81.1, p=0.012). Violent deaths (fatal accidents, intoxications, and suicides) were significantly higher in those diagnosed between 1996 and 2017. SMRs for deaths from renal and cardiovascular disease were higher in this population than in the general Minnesota population Conclusion: All-cause mortality in the T1D population remains higher than in the general population. Mortality risk from acute complications persists, despite advances in diabetes management technologies Disclosure: L. Plaza Enriquez: None. R. Ibrahim: None. S. Rizvi: None. E. Fernandes: None. Y.C. Kudva: Advisory Panel; Novo Nordisk, Vertex Pharmaceuticals Incorporated, Tandem Diabetes Care, Inc. Research Support; Dexcom, Inc., Insulet Corporation.