The rate of end-stage renal disease (ESRD) for patients with type 1 diabetes is lower than was originally thought. Furthermore, the risk of dying from type 1 diabetes during the first 20 to 30 years after diagnosis has dropped by 50%, according to the results of a Finnish study reported in the Journal of the American Medical Association (October 12, 2005).
Earlier estimates forecast that 1 in 5 patients with the disease would develop ESRD sometime during the first 20 years following diagnosis. The new study found, however, that the number is closer to 1 in 50 after 20 years and about 1 in 12 after 30 years of having the disease. For the study, the researchers examined the records of >20,000 Finnish patients diagnosed with type 1 diabetes between 1965 and 1969. All of the patients were under 30 when diagnosed, and they were included in the Finnish Diabetes Register. The participants were followed until they developed ESRD or died or until the study ended on December 31, 2001.
The rate of ESRD was only 2.2% after 20 years of diabetes, compared with earlier estimates of 20%. After 3 decades, the rate was 7.8%. The risk of death fell by 59% from the beginning of the study (1965-1969) to near the end (1980-1999). Generally, 6.8% of the individuals died during the first 20 years, and 15% died at some point during the 30 years after diagnosis. A majority of the deaths occurred among the patients who never developed ESRD, reported the investigators.