{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:28:47Z","timestamp":1785796127540,"version":"3.56.0"},"reference-count":26,"publisher":"American Diabetes Association","issue":"7","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2008,7,1]]},"abstract":"<jats:p>OBJECTIVE\u2014The purpose of this study was to examine risk factors for mortality in patients with type 1 diabetes.<\/jats:p>\n               <jats:p>RESEARCH DESIGN AND METHODS\u2014Baseline risk factors were measured in the EURODIAB Prospective Cohort Study with 2,787 type 1 diabetic patients (51% men and 49% women) recruited from 16 European countries. Mortality data were collected during a 7-year follow-up.<\/jats:p>\n               <jats:p>RESULTS\u2014There was an annual mortality rate of 5 per 1,000 person-years in patients with type 1 diabetes (mean age at baseline 33 years, range 15\u201361 years); of the total 2,787 subjects, 102 died. The final multivariable model contained age at baseline (standardized hazard ratio 1.78 [95% CI 1.44\u20132.20]), A1C (1.18 [0.95\u20131.46]), waist-to-hip ratio (WHR) (1.32 [1.14\u20131.52]), pulse pressure (1.33 [1.13\u20131.58]), and non-HDL cholesterol (1.33 [1.12\u20131.60]) as risk factors for all-cause mortality. Macroalbuminuria (2.39 [1.19\u20134.78]) and peripheral (1.88 [1.06\u20133.35]) and autonomic neuropathy (2.40 [1.32\u20134.36]) were the most important risk markers for mortality. Similar risk factors were found for all-cause, non-cardiovascular disease (CVD), unknown-cause, and CVD mortality.<\/jats:p>\n               <jats:p>CONCLUSIONS\u2014Important risk factors for the increased total and non-CVD mortality in type 1 diabetic patients are age, WHR, pulse pressure, and non-HDL cholesterol. Microvascular complications from macroalbuminuria and peripheral and autonomic neuropathy are strong risk markers for future mortality exceeding the effect of the traditional risk factors.<\/jats:p>","DOI":"10.2337\/dc08-0107","type":"journal-article","created":{"date-parts":[[2008,6,6]],"date-time":"2008-06-06T20:49:14Z","timestamp":1212785354000},"page":"1360-1366","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":192,"title":["Relationship Between Risk Factors and Mortality in Type 1 Diabetic Patients in Europe"],"prefix":"10.2337","volume":"31","author":[{"given":"Sabita S.","family":"Soedamah-Muthu","sequence":"first","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands"},{"name":"Epidemiology and Public Health, Royal Free and University College London Medical School, London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nish","family":"Chaturvedi","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College, London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel R.","family":"Witte","sequence":"additional","affiliation":[{"name":"Epidemiology and Public Health, Royal Free and University College London Medical School, London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynda K.","family":"Stevens","sequence":"additional","affiliation":[{"name":"Epidemiology and Public Health, Royal Free and University College London Medical School, London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Porta","sequence":"additional","affiliation":[{"name":"Medicine, University of Turin, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Fuller","sequence":"additional","affiliation":[{"name":"Epidemiology and Public Health, Royal Free and University College London Medical School, London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the EURODIAB Prospective Complications Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031302074174300_R1","doi-asserted-by":"crossref","unstructured":"Laing SP, Swerdlow AJ, Slater SD, Bothat JL, Burden AC, Waugh NR, Smith AW, Hill RD, Bingley PJ, Patterson CC, Qiao Z, Keen H: The British Diabetic Association Cohort Study, I: all-cause mortality in patients with insulin-treated diabetes mellitus. Diabet Med\u200816: 459\u2013465, 1999","DOI":"10.1046\/j.1464-5491.1999.00075.x"},{"key":"2022031302074174300_R2","doi-asserted-by":"crossref","unstructured":"Soedamah-Muthu SS, Fuller JH, Mulnier HE, Raleigh VS, Lawrenson RA, Colhoun HM: All-cause mortality rates in patients with type 1 diabetes mellitus compared with a non-diabetic population from the UK general practice research database, 1992\u20131999. Diabetologia\u200849:660\u2013666, 2006","DOI":"10.1007\/s00125-005-0120-4"},{"key":"2022031302074174300_R3","doi-asserted-by":"crossref","unstructured":"Soedamah-Muthu SS, Chaturvedi N, Toeller M, Ferris B, Reboldi P, Michel G, Manes C, Fuller JH, EURODIAB Prospective Complications Study Group: Risk factors for coronary heart disease in type 1 diabetic patients in Europe: the EURODIAB Prospective Complications Study (PCS). Diabetes Care\u200827:530\u2013537, 2003","DOI":"10.2337\/diacare.27.2.530"},{"key":"2022031302074174300_R4","doi-asserted-by":"crossref","unstructured":"Olson JC, Erbey JR, Williams KV, Becker DJ, Edmundowicz D, Kelsey SF, Tyrrell KS, Orchard TJ: Subclinical atherosclerosis and estimated glucose disposal rate as predictors of mortality in type 1 diabetes. Ann Epidemiol\u200812:331\u2013337, 2002","DOI":"10.1016\/S1047-2797(01)00269-1"},{"key":"2022031302074174300_R5","doi-asserted-by":"crossref","unstructured":"Stephenson JM, Kenny S, Stevens LK, Fuller JH, Lee E: Proteinuria and mortality in diabetes: the WHO Multinational Study of Vascular Disease in Diabetes. Diabet Med\u200812:149\u2013155, 1995","DOI":"10.1111\/j.1464-5491.1995.tb00446.x"},{"key":"2022031302074174300_R6","doi-asserted-by":"crossref","unstructured":"Rossing P, Hougaard P, Borch-Johnsen K, Parving HH: Predictors of mortality in insulin dependent diabetes: 10 year observational follow up study. BMJ\u2008313:779\u2013784, 1996","DOI":"10.1136\/bmj.313.7060.779"},{"key":"2022031302074174300_R7","doi-asserted-by":"crossref","unstructured":"EURODIAB IDDM Complications Study Group: Microvascular and acute complications in IDDM patients: the EURODIAB IDDM Complications Study. Diabetologia\u200837:278\u2013285, 1994","DOI":"10.1007\/BF00398055"},{"key":"2022031302074174300_R8","doi-asserted-by":"crossref","unstructured":"Koivisto VA, Stevens LK, Mattock M, Ebeling P, Muggeo M, Stephenson J, Idzior WB: Cardiovascular disease and its risk factors in IDDM in Europe: EURODIAB IDDM Complications Study Group. Diabetes Care\u200819:689\u2013697, 1996","DOI":"10.2337\/diacare.19.7.689"},{"key":"2022031302074174300_R9","doi-asserted-by":"crossref","unstructured":"Aldington SJ, Kohner EM, Meuer S, Klein R, Sjolie AK: Methodology for retinal photography and assessment of diabetic retinopathy: the EURODIAB IDDM Complications Study. Diabetologia\u200838:437\u2013444, 1995","DOI":"10.1007\/BF00410281"},{"key":"2022031302074174300_R10","doi-asserted-by":"crossref","unstructured":"Tesfaye S, Chaturvedi N, Eaton SE, Ward JD, Manes C, Ionescu-Tirgoviste C, Witte DR, Fuller JH: Vascular risk factors and diabetic neuropathy. N Engl J Med\u2008352:341\u2013350, 2005","DOI":"10.1056\/NEJMoa032782"},{"key":"2022031302074174300_R11","doi-asserted-by":"crossref","unstructured":"Wiles PG, Pearce SM, Rice PJS, Mitchell JMO: Vibration perception threshold: influence of age, height, sex, and smoking, and calculation of accurate centile values. Diabet Med\u20088:157\u2013161, 1991","DOI":"10.1111\/j.1464-5491.1991.tb01563.x"},{"key":"2022031302074174300_R12","doi-asserted-by":"crossref","unstructured":"The Consensus Committee of the AAS and the AAN: Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy: the Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Neurology\u200846:1470, 1996","DOI":"10.1212\/WNL.46.5.1470"},{"key":"2022031302074174300_R13","doi-asserted-by":"crossref","unstructured":"Witte DR, Tesfaye S, Chaturvedi N, Eaton SE, Kempler P, Fuller JH: Risk factors for cardiac autonomic neuropathy in type 1 diabetes mellitus. Diabetologia\u200848:164\u2013171, 2005","DOI":"10.1007\/s00125-004-1617-y"},{"key":"2022031302074174300_R14","doi-asserted-by":"crossref","unstructured":"Kearney EM, Mount JN, Watts GF, Slavin BM, Kind PR: Simple immunoturbidimetric method for determining urinary albumin at low concentrations using Cobas-Bio centrifugal analyser. J Clin Pathol\u200840:465\u2013468, 1987","DOI":"10.1136\/jcp.40.4.465"},{"key":"2022031302074174300_R15","doi-asserted-by":"crossref","unstructured":"Bucolo G, David H: Quantitative determination of serum triglycerides by the use of enzymes. Clin Chem\u200819:476\u2013482, 1973","DOI":"10.1093\/clinchem\/19.5.476"},{"key":"2022031302074174300_R16","doi-asserted-by":"crossref","unstructured":"Siedel J, Hagele EO, Ziegenhorn J, Wahlefeld AW: Reagent for the enzymatic determination of serum total cholesterol with improved lipolytic efficiency. Clin Chem\u200829:1075\u20131080, 1983","DOI":"10.1093\/clinchem\/29.6.1075"},{"key":"2022031302074174300_R17","doi-asserted-by":"crossref","unstructured":"Warnick GR, Albers JJ: A comprehensive evaluation of the heparin-manganese precipitation procedure for estimating high density lipoprotein cholesterol. J Lipid Res\u200819:65\u201376, 1978","DOI":"10.1016\/S0022-2275(20)41577-9"},{"key":"2022031302074174300_R18","doi-asserted-by":"crossref","unstructured":"Friedewald WT, Levy RI, Fredrickson DS: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem\u200818:499\u2013502, 1972","DOI":"10.1093\/clinchem\/18.6.499"},{"key":"2022031302074174300_R19","doi-asserted-by":"crossref","unstructured":"John WG, Gray MR, Bates DL, Beacham JL: Enzyme immunoassay\u2014a new technique for estimating hemoglobin A1c. Clin Chem\u200839:663\u2013666, 1993","DOI":"10.1093\/clinchem\/39.4.663"},{"key":"2022031302074174300_R20","doi-asserted-by":"crossref","unstructured":"Morrish NJ, Wang SL, Stevens LK, Fuller JH, Keen H: Mortality and causes of death in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia\u200844 (Suppl 2):S14\u2013S21, 2001","DOI":"10.1007\/PL00002934"},{"key":"2022031302074174300_R21","doi-asserted-by":"crossref","unstructured":"Pambianco G, Costacou T, Ellis D, Becker DJ, Klein R, Orchard TJ: The 30-year natural history of type 1 diabetes complications: the Pittsburgh Epidemiology of Diabetes Complications Study experience. Diabetes\u200855:1463\u20131469, 2006","DOI":"10.2337\/db05-1423"},{"key":"2022031302074174300_R22","doi-asserted-by":"crossref","unstructured":"Maser RE, Mitchell BD, Vinik AI, Freeman R: The association between cardiovascular autonomic neuropathy and mortality in individuals with diabetes: a meta-analysis. Diabetes Care\u200826:1895\u20131901, 2003","DOI":"10.2337\/diacare.26.6.1895"},{"key":"2022031302074174300_R23","doi-asserted-by":"crossref","unstructured":"Orchard TJ, Lloyd CE, Maser RE, Kuller LH: Why does diabetic autonomic neuropathy predict IDDM mortality? An analysis from the Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Res Clin Pract\u200834 (Suppl.):S165\u2013S171, 1996","DOI":"10.1016\/S0168-8227(96)90025-X"},{"key":"2022031302074174300_R24","doi-asserted-by":"crossref","unstructured":"Coppini DV, Bowtell PA, Weng C, Young PJ, Sonksen PH: Showing neuropathy is related to increased mortality in diabetic patients\u2014a survival analysis using an accelerated failure time model. J Clin Epidemiol\u200853:519\u2013523, 2000","DOI":"10.1016\/S0895-4356(99)00170-5"},{"key":"2022031302074174300_R25","doi-asserted-by":"crossref","unstructured":"Forsblom CM, Sane T, Groop PH, Totterman KJ, Kallio M, Saloranta C, Laasonen L, Summanen P, Lepantalo M, Laatikainen L, Matikainen E, Teppo AM, Koskimies S, Groop L: Risk factors for mortality in type II (non-insulin-dependent) diabetes: evidence of a role for neuropathy and a protective effect of HLA-DR4. Diabetologia\u200841:1253\u20131262, 1998","DOI":"10.1007\/s001250051062"},{"key":"2022031302074174300_R26","doi-asserted-by":"crossref","unstructured":"van Hecke MV, Dekker JM, Stehouwer CD, Polak BC, Fuller JH, Sjolie AK, Kofinis A, Rottiers R, Porta M, Chaturvedi N: Diabetic retinopathy is associated with mortality and cardiovascular disease incidence: the EURODIAB Prospective Complications Study. Diabetes Care\u200828:1383\u20131389, 2005","DOI":"10.2337\/diacare.28.6.1383"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/31\/7\/1360\/599329\/zdc00708001360.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/31\/7\/1360\/599329\/zdc00708001360.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T01:15:43Z","timestamp":1647134143000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/31\/7\/1360\/39067\/Relationship-Between-Risk-Factors-and-Mortality-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,7,1]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2008,7,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc08-0107","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,7,1]]}}}