All-cause mortality, myocardial infarction and stroke risk in people with diabetes in the UK : studies using the General Practice research database

People with diabetes are at an increased risk of cardiovascular disease (CVD). Published data on risk of all-cause mortality, myocardial infarction (MI) and stroke in type 1 diabetes separately from risk in type 2 diabetes are scarce. Such data that do exist may be derived from studies limited to a specific geographical area with a high background risk of CVD. Cohorts and sample sizes are often small with limited data for the elderly or young. This thesis presents analyses of data taken from the General Practice Research Database (GPRD). This database provides longitudinal data from primary care representative of approximately 5% of the UK population in 1992. Cohorts of patients with type 1 (n 7,713) or type 2 (n 44,230) diabetes were identified and followed from baseline to 1999. Risk of all-cause mortality MI and stroke in type 1 diabetes and type 2 diabetes was compared with that risk in people without diabetes. Patients with type 1 diabetes were at three to four times the risk of death or CVD than their peers without diabetes. In people with type 2 diabetes the risks were generally twice those of people without diabetes. The relative risks stratified by age and sex in type 1 and type 2 diabetes revealed risk was highest in the younger age-groups, reduced with age and that the risk associated with having diabetes was greater for women than for men. Importantly, women with type 1 or type 2 diabetes in their late 50s or early 60s had a risk of CVD that was five times greater than that of women without diabetes. There was little difference between the relative risks associated with type 1 or type 2 diabetes. These data provide an important UK baseline against which the effectiveness of policies introduced after 1999 to reduce the relative risk associated with diabetes can be evaluated.EThOS - Electronic Theses Online ServiceGBUnited Kingdo