Abstract
Background The JEVIN trial started as a cross-sectional study in 1989/90 in Jena. After a follow-up
of more than 20 years, the mortality incidence of JEVIN participants with type 1 diabetes
was surveyed.
Methods 103 (78.6%) of the 131 JEVIN patients participating at baseline could be examined.
38 persons (36.9%) had deceased. All JEVIN survey data and routine examinations documented
in the electronic patient record EMIL® of surviving and deceased participants were
used for analyses. We compared the data of the surviving with the deceased participants
(follow-up time: 2,166 person-years).
Results The incidence rate of death was 1.75/100 person-years. Median observation time for
all patients was 23.1 years (range 0.61–26.6 years). Mean age at death was 58.5 years
(34.2–78.4 years), and diabetes duration 35 years (3.5–68.5 years). Most frequent
causes of death were: cardiovascular diseases (48.2%, n=13) and infections (25.9%,
n=7). There were no differences in age (p=0.302), diabetes duration (p=0.371), BMI
(p=0.535), blood pressure (p=0.622/0.820), gender (p=0.566), and smoking status (p=0.709)
between surviving and deceased persons. The mean HbA1c of the last year before death or last visit was higher in the deceased than surviving
persons (7.5% vs. 7.0%; p=0.010). 57.4% of the surviving and 87.0% of the deceased
participants had nephropathy (p=0.012), 79.7% vs. 89.7% retinopathy (p=0.241) and
61.4% vs. 63.3% neuropathy (p=0.860), but only nephropathy was significantly associated
with increased mortality risk (HR=4.208, CI:1.226-14.440; HR=2.360, CI:0.696-8.004;
HR=0.944, CI:0.436-2.043).
Conclusions In the JEVIN population with diabetes mellitus type 1 only, diabetic nephropathy
was associated with higher mortality risk.
Key words
observational study - Germany - survival - life expectancy
