Long-term (20 years) outcome and mortality of Type 1 diabetic patients in Soweto, South Africa
Aims To assess the long‐term (20 years) mortality, with causes of death, in a cohort of Type 1 diabetic patients resident in Soweto, South Africa. Methods A cohort of Type 1 diabetic patients attending the Diabetic Clinic of Baragwanath Hospital, Soweto were studied in 1982. They were followed ove...
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| Veröffentlicht in: | Diabetic medicine 2005-12, Vol.22 (12), p.1642-1646 |
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| creator | Gill, G. V. Huddle, K. R. L. Monkoe, G. |
| description | Aims To assess the long‐term (20 years) mortality, with causes of death, in a cohort of Type 1 diabetic patients resident in Soweto, South Africa.
Methods A cohort of Type 1 diabetic patients attending the Diabetic Clinic of Baragwanath Hospital, Soweto were studied in 1982. They were followed over the subsequent 20 years, the final investigation being in 2002. Numbers dying during the period were recorded, as well as year of death and cause. The complication status of survivors was also assessed.
Results Of the original cohort of 88 Type 1 patients, 21 died during the follow‐up period. There were 39 lost to follow‐up, giving a crude 20 years’ mortality of 43%. Kaplan–Meier analysis showed mortality hazard of 33%. Of those dying, most (9/21) were as a result of renal failure. Other causes were hypoglycaemia (6), ketoacidosis (2), infection (2) and undetermined (2). Of the survivors, comparing data at 0 and 20 years’ follow‐up, there was a significant increase in rates of retinopathy (P |
| doi_str_mv | 10.1111/j.1464-5491.2005.01712.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69060924</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>69060924</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4352-afc53c155b17f121d40f632bee65ddcef8ede39914e5b0ecce7dc1b51abf8bc63</originalsourceid><addsrcrecordid>eNqNkMtu1DAUQC0EotPCLyBvQFQiwc88FixKKQUxhQUFlsZxrsHTJB5sjzr5m35Lv4yEGbVbvLmWfI5tHYQwJTmd1utVTkUhMilqmjNCZE5oSVm-fYAWdwcP0YKUgmWclPQAHca4IoSymteP0QEtBKGcFAv0c-mHX1mC0OOXjNzejKBDPMZ-k4zvAeuhxb0PSXcujdhbfDmu4faG4tbpBpIzeK2TgyFF7Ab81V9D8q-muUm_8YkNzugn6JHVXYSn-3mEvr0_uzz9kC2_nH88PVlmRnDJMm2N5IZK2dDSUkZbQWzBWQNQyLY1YCtogdc1FSAbAsZA2RraSKobWzWm4Efoxe7edfB_NhCT6l000HV6AL-JqqhJQWomJrDagSb4GANYtQ6u12FUlKi5rlqpOaKaI6q5rvpXV20n9dn-jU3TQ3sv7nNOwPM9oKPRnQ16MC7ecyWnrCJk4t7suGvXwfjfH1DvLs7m3eRnO9_FBNs7X4crVZS8lOrH53N1UYu33yWp1Cf-F2lopgk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>69060924</pqid></control><display><type>article</type><title>Long-term (20 years) outcome and mortality of Type 1 diabetic patients in Soweto, South Africa</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Gill, G. V. ; Huddle, K. R. L. ; Monkoe, G.</creator><creatorcontrib>Gill, G. V. ; Huddle, K. R. L. ; Monkoe, G.</creatorcontrib><description>Aims To assess the long‐term (20 years) mortality, with causes of death, in a cohort of Type 1 diabetic patients resident in Soweto, South Africa.
Methods A cohort of Type 1 diabetic patients attending the Diabetic Clinic of Baragwanath Hospital, Soweto were studied in 1982. They were followed over the subsequent 20 years, the final investigation being in 2002. Numbers dying during the period were recorded, as well as year of death and cause. The complication status of survivors was also assessed.
Results Of the original cohort of 88 Type 1 patients, 21 died during the follow‐up period. There were 39 lost to follow‐up, giving a crude 20 years’ mortality of 43%. Kaplan–Meier analysis showed mortality hazard of 33%. Of those dying, most (9/21) were as a result of renal failure. Other causes were hypoglycaemia (6), ketoacidosis (2), infection (2) and undetermined (2). Of the survivors, comparing data at 0 and 20 years’ follow‐up, there was a significant increase in rates of retinopathy (P < 0.02) and hypertension (P < 0.005), but not of other complications.
Conclusions This is the first long‐term outcome study of Type 1 diabetes in sub‐Saharan Africa. Although the mortality was substantial, it is similar to equivalent studies of United States (US) Afro‐Americans with Type 1 diabetes. The major cause of death was renal failure related to diabetic nephropathy, and reflects lack of adequate facilities for renal replacement therapy. Despite the deprivation, poverty, political upheaval and recent AIDS epidemic in Soweto, Type 1 diabetes carries a reasonable long‐term prognosis, and survivors are generally free of debilitating complications.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/j.1464-5491.2005.01712.x</identifier><identifier>PMID: 16401306</identifier><identifier>CODEN: DIMEEV</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Adolescent ; Adult ; Africa ; Biological and medical sciences ; Cause of Death ; Cohort Studies ; Diabetes Mellitus, Type 1 - mortality ; Diabetes. Impaired glucose tolerance ; Diabetic Neuropathies - mortality ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Humans ; Kidney Failure, Chronic - mortality ; Longitudinal Studies ; Male ; Medical sciences ; mortality ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Prognosis ; Renal failure ; Sex Distribution ; South Africa - epidemiology ; Type 1 diabetes</subject><ispartof>Diabetic medicine, 2005-12, Vol.22 (12), p.1642-1646</ispartof><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4352-afc53c155b17f121d40f632bee65ddcef8ede39914e5b0ecce7dc1b51abf8bc63</citedby><cites>FETCH-LOGICAL-c4352-afc53c155b17f121d40f632bee65ddcef8ede39914e5b0ecce7dc1b51abf8bc63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1464-5491.2005.01712.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1464-5491.2005.01712.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17312800$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16401306$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gill, G. V.</creatorcontrib><creatorcontrib>Huddle, K. R. L.</creatorcontrib><creatorcontrib>Monkoe, G.</creatorcontrib><title>Long-term (20 years) outcome and mortality of Type 1 diabetic patients in Soweto, South Africa</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>Aims To assess the long‐term (20 years) mortality, with causes of death, in a cohort of Type 1 diabetic patients resident in Soweto, South Africa.
Methods A cohort of Type 1 diabetic patients attending the Diabetic Clinic of Baragwanath Hospital, Soweto were studied in 1982. They were followed over the subsequent 20 years, the final investigation being in 2002. Numbers dying during the period were recorded, as well as year of death and cause. The complication status of survivors was also assessed.
Results Of the original cohort of 88 Type 1 patients, 21 died during the follow‐up period. There were 39 lost to follow‐up, giving a crude 20 years’ mortality of 43%. Kaplan–Meier analysis showed mortality hazard of 33%. Of those dying, most (9/21) were as a result of renal failure. Other causes were hypoglycaemia (6), ketoacidosis (2), infection (2) and undetermined (2). Of the survivors, comparing data at 0 and 20 years’ follow‐up, there was a significant increase in rates of retinopathy (P < 0.02) and hypertension (P < 0.005), but not of other complications.
Conclusions This is the first long‐term outcome study of Type 1 diabetes in sub‐Saharan Africa. Although the mortality was substantial, it is similar to equivalent studies of United States (US) Afro‐Americans with Type 1 diabetes. The major cause of death was renal failure related to diabetic nephropathy, and reflects lack of adequate facilities for renal replacement therapy. Despite the deprivation, poverty, political upheaval and recent AIDS epidemic in Soweto, Type 1 diabetes carries a reasonable long‐term prognosis, and survivors are generally free of debilitating complications.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Africa</subject><subject>Biological and medical sciences</subject><subject>Cause of Death</subject><subject>Cohort Studies</subject><subject>Diabetes Mellitus, Type 1 - mortality</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Neuropathies - mortality</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - mortality</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical sciences</subject><subject>mortality</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Prognosis</subject><subject>Renal failure</subject><subject>Sex Distribution</subject><subject>South Africa - epidemiology</subject><subject>Type 1 diabetes</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMtu1DAUQC0EotPCLyBvQFQiwc88FixKKQUxhQUFlsZxrsHTJB5sjzr5m35Lv4yEGbVbvLmWfI5tHYQwJTmd1utVTkUhMilqmjNCZE5oSVm-fYAWdwcP0YKUgmWclPQAHca4IoSymteP0QEtBKGcFAv0c-mHX1mC0OOXjNzejKBDPMZ-k4zvAeuhxb0PSXcujdhbfDmu4faG4tbpBpIzeK2TgyFF7Ab81V9D8q-muUm_8YkNzugn6JHVXYSn-3mEvr0_uzz9kC2_nH88PVlmRnDJMm2N5IZK2dDSUkZbQWzBWQNQyLY1YCtogdc1FSAbAsZA2RraSKobWzWm4Efoxe7edfB_NhCT6l000HV6AL-JqqhJQWomJrDagSb4GANYtQ6u12FUlKi5rlqpOaKaI6q5rvpXV20n9dn-jU3TQ3sv7nNOwPM9oKPRnQ16MC7ecyWnrCJk4t7suGvXwfjfH1DvLs7m3eRnO9_FBNs7X4crVZS8lOrH53N1UYu33yWp1Cf-F2lopgk</recordid><startdate>200512</startdate><enddate>200512</enddate><creator>Gill, G. V.</creator><creator>Huddle, K. R. L.</creator><creator>Monkoe, G.</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200512</creationdate><title>Long-term (20 years) outcome and mortality of Type 1 diabetic patients in Soweto, South Africa</title><author>Gill, G. V. ; Huddle, K. R. L. ; Monkoe, G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4352-afc53c155b17f121d40f632bee65ddcef8ede39914e5b0ecce7dc1b51abf8bc63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Africa</topic><topic>Biological and medical sciences</topic><topic>Cause of Death</topic><topic>Cohort Studies</topic><topic>Diabetes Mellitus, Type 1 - mortality</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Neuropathies - mortality</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - mortality</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical sciences</topic><topic>mortality</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Prognosis</topic><topic>Renal failure</topic><topic>Sex Distribution</topic><topic>South Africa - epidemiology</topic><topic>Type 1 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gill, G. V.</creatorcontrib><creatorcontrib>Huddle, K. R. L.</creatorcontrib><creatorcontrib>Monkoe, G.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gill, G. V.</au><au>Huddle, K. R. L.</au><au>Monkoe, G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term (20 years) outcome and mortality of Type 1 diabetic patients in Soweto, South Africa</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2005-12</date><risdate>2005</risdate><volume>22</volume><issue>12</issue><spage>1642</spage><epage>1646</epage><pages>1642-1646</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><coden>DIMEEV</coden><abstract>Aims To assess the long‐term (20 years) mortality, with causes of death, in a cohort of Type 1 diabetic patients resident in Soweto, South Africa.
Methods A cohort of Type 1 diabetic patients attending the Diabetic Clinic of Baragwanath Hospital, Soweto were studied in 1982. They were followed over the subsequent 20 years, the final investigation being in 2002. Numbers dying during the period were recorded, as well as year of death and cause. The complication status of survivors was also assessed.
Results Of the original cohort of 88 Type 1 patients, 21 died during the follow‐up period. There were 39 lost to follow‐up, giving a crude 20 years’ mortality of 43%. Kaplan–Meier analysis showed mortality hazard of 33%. Of those dying, most (9/21) were as a result of renal failure. Other causes were hypoglycaemia (6), ketoacidosis (2), infection (2) and undetermined (2). Of the survivors, comparing data at 0 and 20 years’ follow‐up, there was a significant increase in rates of retinopathy (P < 0.02) and hypertension (P < 0.005), but not of other complications.
Conclusions This is the first long‐term outcome study of Type 1 diabetes in sub‐Saharan Africa. Although the mortality was substantial, it is similar to equivalent studies of United States (US) Afro‐Americans with Type 1 diabetes. The major cause of death was renal failure related to diabetic nephropathy, and reflects lack of adequate facilities for renal replacement therapy. Despite the deprivation, poverty, political upheaval and recent AIDS epidemic in Soweto, Type 1 diabetes carries a reasonable long‐term prognosis, and survivors are generally free of debilitating complications.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>16401306</pmid><doi>10.1111/j.1464-5491.2005.01712.x</doi><tpages>5</tpages></addata></record> |
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| subjects | Adolescent Adult Africa Biological and medical sciences Cause of Death Cohort Studies Diabetes Mellitus, Type 1 - mortality Diabetes. Impaired glucose tolerance Diabetic Neuropathies - mortality Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Humans Kidney Failure, Chronic - mortality Longitudinal Studies Male Medical sciences mortality Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Prognosis Renal failure Sex Distribution South Africa - epidemiology Type 1 diabetes |
| title | Long-term (20 years) outcome and mortality of Type 1 diabetic patients in Soweto, South Africa |
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