ArticleBMJ (Clinical research ed.)1996
Predictors of mortality in insulin dependent diabetes: 10 year observational follow up study.
Article in BMJ (Clinical research ed.), 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 111 papers, 3 of them syntheses that pooled it.
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Who cites it
111 citing papers in PubMed, 3 syntheses or guidelines pooled it, 434 citations in OpenAlex.
- Socioeconomic inequalities in mortality, morbidity and diabetes management for adults with type 1 diabetes: A systematic review.PloS one · 2017Pooled it
- A Systematic Review of Cost-Effectiveness Models in Type 1 Diabetes Mellitus.PharmacoEconomics · 2016Pooled it
- Pooled it
- Eicosapentaenoic and Docosahexaenoic Acids Attenuate Progression of Albuminuria in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease.Journal of the American Heart Association · 2017Trial
- Telemedicine home blood pressure measurements and progression of albuminuria in elderly people with diabetes.Hypertension (Dallas, Tex. : 1979) · 2008Trial
- Increased small dense LDL and intermediate-density lipoprotein with albuminuria in type 1 diabetes.Diabetes care · 1999Trial
- Developments in albuminuria testing: A key biomarker for detection, prognosis and surveillance of kidney and cardiovascular disease-A practical update for clinicians.Diabetes, obesity & metabolism · 2025Review
- Insulin Resistance in Type 1 Diabetes: Pathophysiological, Clinical, and Therapeutic Relevance.Endocrine reviews · 2025Review
- Esm-1 mediates transcriptional polarization associated with diabetic kidney disease.American journal of physiology. Renal physiology · 2024Article
- Patients with type 1 diabetes and albuminuria have a reduced brain glycolytic capability that is correlated with brain atrophy.Frontiers in neuroscience · 2023Article
- Pancreatic transplant surgery and stem cell therapy: Finding the balance between therapeutic advances and ethical principles.World journal of stem cells · 2022Review
- Diagnostic and therapeutic characteristics of diabetes mellitus and risk of out-of-hospital cardiac arrest.Scientific reports · 2022Article
- All-cause and cardiovascular disease mortality in underweight patients with diabetic nephropathy: BioBank Japan cohort.Journal of diabetes investigation · 2021Article
- Plasminogen Deficiency and Amiloride Mitigate Angiotensin II-Induced Hypertension in Type 1 Diabetic Mice Suggesting Effects Through the Epithelial Sodium Channel.Journal of the American Heart Association · 2020Article
- Impact of Pancreas Transplantation on the Patient Survival-An Analysis of the Japanese Pancreas Transplants Registry.Journal of clinical medicine · 2020Article
- Article
- Vascular Complication in Adolescents With Diabetes Mellitus.Frontiers in endocrinology · 2020Review
- Subclinical Organ Damage in Children and Adolescents with Hypertension: Current Guidelines and Beyond.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2019Review
- Molecular form and concentration of serum αScientific reports · 2019Article
- Urinary AQP5 is independently associated with eGFR decline in patients with type 2 diabetes and nephropathy.Diabetes research and clinical practice · 2019Article
51 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the prognostic significance of microalbuminuria and overt diabetic nephropathy and other putative risk factors for cardiovascular and all cause mortality in insulin dependent diabetes.
designTen year observational follow up study.
settingOutpatient diabetic clinic in a tertiary referral centre. SUBJECTS: All 939 adults with insulin dependent diabetes (duration of diabetes five years or more) attending the clinic in 1984; 593 had normal urinary albumin excretion (< or = 30 mg/24 h), 181 persistent microalbuminuria (31-299 mg/24 h), and 165 overt nephropathy (> or = 300 mg/24 h).
main outcome measureAll cause and cardiovascular mortality.
resultsFifteen per cent of patients (90/593) with normoalbuminuria, 25% (45/181) with microalbuminuria, and 44% (72/165) with overt nephropathy at baseline died during follow up. Cox multiple regression analysis identified the following significant predictors of all cause mortality: male sex (relative risk 2.03; 95% confidence interval 1.37 to 3.02), age (1.07; 1.06 to 1.08), height (0.96; 0.94 to 0.98), smoking (1.51; 1.09 to 2.08), social class V versus social class IV (1.70; 1.25 to 2.31), log10 urinary albumin excretion (1.45; 1.18 to 1.77), hypertension (1.63; 1.18 to 2.25), log10 serum creatinine concentration (8.96; 3.34 to 24.08), and haemoglobin A1c concentration (1.11; 1.03 to 1.20). Age, smoking, microalbuminuria, overt nephropathy, and hypertension were significant predictors of cardiovascular mortality. Mortality in patients with microalbuminuria was only slightly increased compared with that in patients with normoalbuminuria. Median survival time after the onset of overt diabetic nephropathy was 13.9 years (95% confidence interval 11.8 to 17.2 years).
conclusionsAbnormally increased urinary albumin excretion and other potentially modifiable risk factors such as hypertension, smoking, poor glycaemic control, and social class predict increased mortality in insulin dependent diabetes. Microalbuminuria by itself confers only a small increase in mortality. The prognosis of patients with overt diabetic nephropathy has improved, probably owing to effective antihypertensive treatment.
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