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Early deaths from ischaemic heart disease in childhood-onset type 1 diabetes
  1. Trina C Evans-Cheung1,
  2. H Jonathan Bodansky1,2,
  3. Roger C Parslow1,
  4. Richard G Feltbower1
  1. 1 Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, UK
  2. 2 Leeds General Infirmary, The Leeds Teaching Hospitals NHS Trust, Leeds, UK
  1. Correspondence to Dr Richard G Feltbower, Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; r.g.feltbower{at}


Aims The risk of ischaemic heart disease (IHD) death in early type 1 diabetes onset was assessed using death certification data.

Methods The Yorkshire Register of type 1 Diabetes in Children and Young People was linked to clinically validated death certification data for those diagnosed under 15 years. Standardised mortality ratios (SMRs) were calculated using the England and Wales population and IHD death rates between 1978 and 2014 by 5-year age group and sex.

Results The cohort included 4382 individuals (83 097 person years). Of 156 deaths, nine were classed as IHD deaths before clinical validation. After clinical validation, 14 IHD deaths were classified, with an SMR of 13.8 (95% CI 8.2 to 23.3) and median age at death of 35.1 years (range 21.9–47.9 years).

Conclusions There is an early emergence of death from IHD in early onset type 1 diabetes. Underascertainment of IHD deaths was present without clinical validation of death certification.

  • epidemiology
  • diabetes

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  • Contributors TCE-C analysed the data and wrote the manuscript. HJB provided clinical validation of death certification data and reviewed the manuscript. RCP and RGF contributed to the discussion and reviewed/edited the manuscript.

  • Funding The YRDCYP currently receives funding from the Yorkshire and Humber Paediatric Diabetes network via the Leeds Teaching Hospitals NHS Trust. TCE-C is funded by a University of Leeds 110 Anniversary Research Scholarship.

  • Competing interests None declared.

  • Ethics approval National Ethics Research Service.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Presented at This paper was presented at the 52nd EASD Annual meeting: Bodansky HJ, Evans-Cheung TC, Parslow RC, Feltbower RG. Premature deaths from ischaemic heart disease in childhood and young adult onset type 1 diabetes. Diabetologia (2016) 59 (Suppl 1): 1.