Prevalence, incidence and mortality of type 1 and type 2 diabetes in Denmark 1996-2016 - PubMed (original) (raw)

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Prevalence, incidence and mortality of type 1 and type 2 diabetes in Denmark 1996-2016

Bendix Carstensen et al. BMJ Open Diabetes Res Care. 2020 May.

Abstract

Introduction: The objective of this study was to give an overview of prevalence, incidence and mortality of type 1 (T1D) and type 2 diabetes (T2D) in Denmark, and their temporal trends.

Research design and methods: We constructed a diabetes register from existing population-based healthcare registers, including a classification of patients as T1D or T2D, with coverage from 1996 to 2016. Using complete population records for Denmark, we derived prevalence, incidence, mortality and standardized mortality ratio (SMR).

Results: The overall prevalence of diabetes at 2016 was 0.5% for T1D and 4.4% for T2D, with annual increases since 1996 of 0.5% for T1D and 5.5% for T2D. Incidence rates of T1D decreased by 3.5% per year, with increase for persons under 25 years of age and a decrease for older persons. T2D incidence increased 2.5% per year until 2011, decreased until 2014 and increased after that, similar in all ages. The annual decrease in mortality was 0.3% for T1D and 2.9% for T2D. The mortality rate ratio between T1D and T2D was 1.9 for men and 1.6 for women. SMR decreased annually 2% for T1D and 0.5% for T2D.

Conclusions: Incidence and prevalence of diabetes is increasing, but mortality among patients with diabetes in Denmark is decreasing faster than the mortality among persons without diabetes. T1D carries a 70% higher mortality than T2D.

Keywords: epidemiology; incidence; mortality; registries.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Conflict of interest statement

Competing interests: BC and MEJ own shares in NovoNordisk. BC has received lecture and consultancy fees from NovoNordisk and LeoPharma. MEJ is PI on a trial sponsored by AstraZeneca, and received research grants from AMGEN AB, AstraZeneca, Sanofi Aventis and Boehringer Ingelheim. PFR has nothing to disclose.

Figures

Figure 1

Figure 1

Age-specific prevalence of type 1 diabetes (A, B) and type 2 diabetes (C, D) in Denmark as of 1 January 1996, 2003,…, 2017. Note the different y-axes in the upper and lower panels. Blue curves are men, red curves women; shaded areas represent 95% CIs. (A) men, type 1 diabetes; (B) women, type 1 diabetes; (C) men, type 2 diabetes; (D) women, type 2 diabetes.

Figure 2

Figure 2

Age-specific incidence rates in different ages as of 1 January 2015, derived from age–period–cohort models. Note the different y-axes in the upper and lower panels but that the relative extent of the axes is the same for type 1 diabetes and type 2 diabetes. Blue curves are men, red curves women; shaded areas represent 95% CIs. (A) men, type 1 diabetes; (B) women, type 1 diabetes; (C) men, type 2 diabetes; (D) women, type 2 diabetes.

Figure 3

Figure 3

Age-specific mortality rates (A, B) and SMR (C, D) as of 1 January 2015 for type 1 diabetes (A, C) and type 2 diabetes (B, D). Each curve represents the mortality among patients diagnosed at ages 15, 25, 35, 45, 55 (type 1 diabetes) respectively 30, 40, 50, 60, 70 (type 2 diabetes), indicated by gray vertical lines. Each curve thus represents the joint effect of attained age and duration of diabetes for a given age at diagnosis and duration from 0 to 20 years. Thick dotted curves are from a model ignoring age at diagnosis and duration of diabetes; thin full lines additionally include prevalent cases as of 1 January 1996 in the modeling. Blue curves are men, red curves women. SMR, standardized mortality ratio.

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