Survival Rates and Mortality Risk Factors of Thai Patients with Type 2 Diabetes Mellitus
Udom Krairittichai MD*, Somkiat Potisat MD**
Affiliation : * Department of Medicine, Rajavithi Hospital College of Medicine, Rangsit University, Bangkok, Thailand ** Institute of Medical Research and Technology Assessment, Department of Medical Service, MOPH, Nonthaburi, Thailand
Background : Type 2 diabetes mellitus (T2DM) is a common public health problem due to both its micro- and macro-vascular
chronic complications. Data on survival rates and mortality risk factors of T2DM in Thailand need to be investigated and
updated.
Objective : To assess the survival rate and mortality risk factors in T2DM patients.
Material and Method: This study is a part of the Thai DMS Diabetes Complications project which is a prospective
observational 4-year study of Thai T2DM patients. All patients were recruited from out-patient departments of seven public
hospitals and received standard treatment from their doctors. Their clinical and laboratory status were evaluated annually
over 4 years, with particular emphasis on diabetic nephropathy, retinopathy and neuropathy. Outcomes at the end of the four-
year study were expressed as survival or death, and causes of mortality were identified.
Results : 1,097 from 1,120 stable T2DM patients were enrolled. After 4 years of follow-up, 80 patients (7.3%) had died.
Causes of death were: cardiovascular disease (20 cases, 25.0%); infection (20 cases, 25.0%); malignancy (10 cases,
12.5%); end-stage renal disease (4 cases, 5.0%); and other causes (26 cases, 32.5%). Survival rates at 1, 2, 3, and 4 years
were 98.9, 97.5, 96.2 and 92.7% respectively. Hazard ratios (95% CI) of all-cause mortality were being over 60 years old
1.84 (1.15-2.94) and having diabetic nephropathy 1.75 (1.12-2.75). Survival rates from cardiovascular mortality at 1, 2, 3,
and 4 years were 99.2, 98.4, 97.4 and 94.5% respectively. Hazard ratios (95% CI) of cardiovascular mortality were: female
gender 1.75 (1.05-2.94); diabetic nephropathy 1.72 (1.03-2.88); and diabetic retinopathy 1.74 (1.02-2.94).
Conclusion : The survival rate of Thai patients with T2DM over the 4 years was 92.7%. Being over 60 years old and having
diabetic nephropathy were associated with all-cause mortality. Female gender, diabetic nephropathy and diabetic retinopathy
were associated with cardiovascular mortality.
Keywords : Diabetes mellitus, Survival rate, Mortality risk factor
