Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Jul;59(7):1803-8.
doi: 10.2337/db09-1744. Epub 2010 Apr 27.

Cumulative risk, age at onset, and sex-specific differences for developing end-stage renal disease in young patients with type 1 diabetes: a nationwide population-based cohort study

Anna Möllsten  1 , Maria Svensson, Ingeborg Waernbaum, Yonas Berhan, Staffan Schön, Lennarth Nyström, Hans J Arnqvist, Gisela Dahlquist; Swedish Childhood Diabetes Study Group; Diabetes Incidence Study in Sweden; Swedish Renal Registry
Affiliations

Cumulative risk, age at onset, and sex-specific differences for developing end-stage renal disease in young patients with type 1 diabetes: a nationwide population-based cohort study

Anna Möllsten et al. Diabetes. 2010 Jul.

Abstract

Objective: This study aimed to estimate the current cumulative risk of end-stage renal disease (ESRD) due to diabetic nephropathy in a large, nationwide, population-based prospective type 1 diabetes cohort and specifically study the effects of sex and age at onset.

Research design and methods: In Sweden, all incident cases of type 1 diabetes aged 0-14 years and 15-34 years are recorded in validated research registers since 1977 and 1983, respectively. These registers were linked to the Swedish Renal Registry, which, since 1991, collects data on patients who receive active uremia treatment. Patients with > or =13 years duration of type 1 diabetes were included (n = 11,681).

Results: During a median time of follow-up of 20 years, 127 patients had developed ESRD due to diabetic nephropathy. The cumulative incidence at 30 years of type 1 diabetes duration was low, with a male predominance (4.1% [95% CI 3.1-5.3] vs. 2.5% [1.7-3.5]). In both male and female subjects, onset of type 1 diabetes before 10 years of age was associated with the lowest risk of developing ESRD. The highest risk of ESRD was found in male subjects diagnosed at age 20-34 years (hazard ratio 3.0 [95% CI 1.5-5.7]). In female subjects with onset at age 20-34 years, the risk was similar to patients' diagnosed before age 10 years.

Conclusions: The cumulative incidence of ESRD is exceptionally low in young type 1 diabetic patients in Sweden. There is a striking difference in risk for male compared with female patients. The different patterns of risk by age at onset and sex suggest a role for puberty and sex hormones.

PubMed Disclaimer

Figures

FIG. 1.
FIG. 1.
Cumulative incidences of developing ESRD in male and female patients with type 1 diabetes onset at 0–9, 10–19, and 20–34 years. For patients with diabetes onset before 10 or 10–19 years of age, there is no significant difference between male and female subjects (P = 0.53 and P = 0.50), but with onset at 20–34 years of age there is a difference, although borderline significant, between male and female subjects in risk of developing ESRD (P = 0.05).
FIG. 2.
FIG. 2.
Cumulative incidences of developing ESRD in male and female patients according to age at onset of type 1 diabetes. When using age at onset 0–9 years as reference, the risk of ESRD is significantly increased with age at onset 10–19 years and 20–34 years for male subjects. For female subjects, the risk is significantly increased with age at onset 10–19 years but not 20–34 years.
See this image and copyright information in PMC

References

    1. Borch-Johnsen K, Andersen PK, Deckert T: The effect of proteinuria on relative mortality in type 1 (insulin- dependent) diabetes mellitus. Diabetologia 1985;28:590–596 - PubMed
    1. Patterson CC, Dahlquist GG, Gyurus E, Green A, Soltesz G: Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study. Lancet 2009;373:2027–2033 - PubMed
    1. Pundziute-Lyckå A, Dahlquist G, Nystrom L, Arnqvist H, Bjork E, Blohme G, Bolinder J, Eriksson JW, Sundkvist G, Ostman J: The incidence of Type I diabetes has not increased but shifted to a younger age at diagnosis in the 0–34 years group in Sweden 1983–1998. Diabetologia 2002;45:783–791 - PubMed
    1. Nordwall M, Bojestig M, Arnqvist HJ, Ludvigsson J: Declining incidence of severe retinopathy and persisting decrease of nephropathy in an unselected population of type 1 diabetes-the Linkoping Diabetes Complications Study. Diabetologia 2004;47:1266–1272 - PubMed
    1. Nathan DM, Zinman B, Cleary PA, Backlund JY, Genuth S, Miller R, Orchard TJ: Modern-day clinical course of type 1 diabetes mellitus after 30 years' duration: the diabetes control and complications trial/epidemiology of diabetes interventions and complications and Pittsburgh epidemiology of diabetes complications experience (1983–2005). Arch Intern Med 2009;169:1307–1316 - PMC - PubMed

Publication types

MeSH terms