2384-P: Mortality in a Contemporary Type 1 Diabetes Cohort: The CACTI Study

by sugaradmin



Introduction and Objective: All-cause mortality has been on the decline among people with type 1 diabetes (T1D). Despite this trend, excess mortality remains high among people with T1D compared to those without T1D. We examined the all-cause and cause-specific mortality in a contemporary T1D cohort and explored factors that influenced mortality.Methods: Participants in the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study followed from 2000 to 2023 were included in this retrospective analysis. Of the 1415 individuals recruited, 652 had T1D with a minimum duration of 10 years. Surveillance for mortality was conducted annually through the Colorado vital records department and through the National Death Index. Mortality and cause-specific hazard ratios were estimated using Cox proportional hazard models stratified by diabetes status.Results: During the follow-up period, there were a total of 125 deaths (89 among people with T1D and 36 among people without T1D). T1D was associated with a 3.37-fold higher hazard of all-cause mortality compared to the non-diabetic group (95% CI: 2.20 – 5.14). In cause-specific analyses, T1D was associated with a higher hazard of mortality from cardiovascular disease (CVD) (HR = 6.57; 95% CI: 1.91-22.50), trauma (HR = 3.69; 95% CI: 1.19-11.50) and other causes of death (HR = 2.47; 95% CI: 1.00-6.11). In contrast, individuals with T1D had a lower but non-significant hazard of cancer-related mortality compared to those without T1D (HR = 0.63; 95% CI: 0.30-1.29). Among individuals with T1D, the hazard of mortality increased with age (HR = 1.06; 95% CI: 1.04-1.08), systolic blood pressure (HR = 1.03; 95% CI: 1.02-1.04), LDL cholesterol (HR = 1.01; 95% CI: 1.00-1.02), and current or former smoking status (HR = 1.78; 95% CI: 1.24-2.55).Conclusion: T1D was associated with more than a 3-fold increased risk of mortality from cardiovascular and trauma related causes, highlighting the remaining burden of this disease on life expectancy. These results suggest that management of CVD risk factors could be further improved in adults with T1D.

Disclosure

P.A. Mensah: None. J. Snell-Bergeon: None. C. Chartier-Logan: None.



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