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Incidence, prevalence and mortality of type 2 diabetes requiring glucose-lowering treatment, and associated risks of cardiovascular complications: a nationwide study in Sweden, 2006-2013
Karolinska Univ Hosp, Cardiol Unit, Dept Med, Karolinska Inst, S-17176 Stockholm, Sweden.;Capio St Gorans Hosp, Stockholm, Sweden..
Astra Zeneca Nord Balt, Sodertalje, Sweden..
Karolinska Inst, Dept Clin Sci & Educ, Div Internal Med, Unit Diabet Res, Stockholm, Sweden..
Statisticon AB, Uppsala, Sweden..
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2016 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 59, no 8, 1692-1701 p.Article in journal (Refereed) Published
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Abstract [en]

Aims/hypothesis The global diabetes epidemic affects countries differently. We aimed to describe trends in the incidence and prevalence of type 2 diabetes mellitus requiring glucose-lowering treatment, together with associated life expectancy and risks of significant clinical complications. Methods Data on patients with type 2 diabetes who filled a prescription for any glucose-lowering drug (GLD) during the period 2006-2013 were extracted from the Swedish Prescribed Drug Register, Cause of Death Register and Swedish National Patient Register. Results In 2013, the prevalence of GLD-treated type 2 diabetes was 4.4% (n = 352,436) and the incidence was 399 per 100,000 population (n = 30,620). During 2006-2013, the prevalence increased by 61% while the incidence remained relatively stable; the prevalence of cardiovascular disease (CVD, 34% in 2013) and microvascular disease (16% in 2013) was also stable. Insulin use increased by 29% while sulfonylurea use declined by 55%. Compared with the general population, patients with type 2 diabetes had increased risk of myocardial infarction, stroke and all-cause mortality, with age-standardised risks of similar to 1.7-, 1.5- and 1.3-fold, respectively. These risks declined over time. Life-years lost due to diabetes was most pronounced at younger ages and improved in women over time from 2006 to 2013. Conclusions/interpretation The prevalence of type 2 diabetes requiring GLD treatment in Sweden increased substantially in recent years, while the incidence remained stable. Use of sulfonylurea declined while insulin use increased. The high prevalence of diabetes-related comorbidities, increased risk of complications and life-years lost highlights the need for optimised and new preventive strategies in patients with type 2 diabetes.

Place, publisher, year, edition, pages
2016. Vol. 59, no 8, 1692-1701 p.
Keyword [en]
Cardiovascular disease, Glucose-lowering therapy, Incidence, Life expectancy, Mortality, Prevalence, Type 2 diabetes
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:uu:diva-300034DOI: 10.1007/s00125-016-3971-yISI: 000379158800016PubMedID: 27189067OAI: oai:DiVA.org:uu-300034DiVA: diva2:950785
Funder
AstraZeneca
Available from: 2016-08-02 Created: 2016-08-02 Last updated: 2016-08-02Bibliographically approved

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