Type 2 diabetes mortality risk declining

Death rates among people with Type 2 diabetes have fallen sharply in Canada and the United Kingdom since the mid-1990s, researchers say.

The excess mortality risk among those with diabetes compared with those without the condition decreased over time in both Canada and the U.K., Dr. Lorraine Lipscombe, an endocrinologist at Women's College Hospital in Toronto, said in Thursday's issue of Diabetologia, the Journal of the European Association for the Study of Diabetes.

The excess risk of mortality estimated during 2009 was 51 per cent in Ontario compared with 90 per cent in 1996.

"The hypothesis is that the mortality rates for diabetes have gone down in part because we're taking better care of our diabetes patients," Lipscombe said.

The risk declined by a similar degree for men and women over the study period.

In 2008-09, nearly 2.4 million Canadians aged one year and older were living with diagnosed diabetes, either Type 1 or Type 2, according to the Public Health Agency of Canada.

The researchers cautioned it's possible there are now more newly diagnosed patients who have had diabetes for a shorter period, since recent guidelines focus on screening high-risk groups.

In the last 10 years, guidelines have stressed aggressive control of blood pressure, cholesterol and hyperglycemia in people with diabetes, so patients may now be receiving more intensive care.

The prevalence of diabetes was higher in Ontario than in the U.K., where the risk fell to 65 per cent in 2009 compared with 114 per cent in 1996.

It's not clear why, but factors such as screening programs, ethnicity, eating habits or physical activity patterns could be contributing, the researchers speculated. Ontario’s population was also relatively constant over time while the U.K. group increased.

Factors that influence death rates, such as cardiovascular disease and smoking, were not explored. Lipscombe hopes to check if there is a similar trend for cardiovascular disease in the province.

The study was funded by Ontario's Ministry of Health and Long-Term Care and an unrestricted grant from AstraZeneca and Novo Dordisk Scandinavia.