Cancer has overtaken cardiovascular disease (CVD) as the most common cause of death in Scottish adults with type 2 diabetes, according to a study published in the Journal of Diabetes Investigation.
Forty-six out of 55 general practices in NHS Ayrshire & Arran contributed data in 2009 and 2014. The causes of death were clustered into nine categories: heart disease, stroke, infection, renal failure, respiratory disorders, cancer, mental health, decompensated diabetes and other, and were compared to national rates.
In 2009, there were 10,679 people with type 2 diabetes in the cohort. In 2014, 1764 had died, giving a five-year mortality rate of 165.2 per 1000 people. By comparison, the Scottish mortality rate over the same period, using the same age profile, was estimated as 113.7 per 1000 patients. Hence, the standardised mortality ratio (SMR) for people with type 2 diabetes was 145. The SMR was consistently higher for women.
The main cause of death was cancer (28%), followed by heart disease (24%), with more male deaths from cancer and heart disease and more female deaths in all other categories.
This is the first study to demonstrate that cancer is the major contributing cause of the increase in all-cause mortality seen in type 2 diabetes patients in the UK.
The authors say the findings suggest that where cardiovascular risk factors are being treated aggressively, cancer takes on greater importance in the cause of death among patients with type 2 diabetes. They ask if greater consideration should now be given to cancer as a complication of diabetes.