Sudden cardiac death risk is greatly increased among young people with diabetes

Takeaway

• Sudden cardiac death (SCD) rate is almost 9-fold greater among people ages 1-35 years with diabetes vs those without it.

Why this matters

• Diabetes is a well-established risk factor for SCD.

Study design

• Danish databases, 1363 SCD cases identified, 2000-2009.
• Among the 14,294 who died, 5% (669) had diabetes, of whom 118 had SCD (9% of all SCD).
• Funding: Novo Nordisk Foundation.

Key results

• With diabetes:
  • Less frequent medicolegal external examinations: 50% vs 76% without diabetes; and 
  • Less frequent autopsies: 32% vs 57% (both P<.001).
• Among those ages 1-35 years, age- and sex-standardized SCD incidence rates (IRs) per 100,000 person-years were:
  • 21.9 (95% CI, 14.9-72.5) with diabetes vs
  • 2.6 (95% CI, 2.4-2.8) without;
  • IR ratio 8.6 (95% CI, 5.8-28.6).
• For ages 36-49 years, SCD IRs per 100,000 person-years were:
  • 119.8 (95% CI, 93.7-152.1) with diabetes vs 
  • 19.7 (95% CI, 18.2-21.2);
  • IR ratio, 6.1 (95% CI, 4.7-7.8).
• SCD IR ratios with vs without type 1 diabetes were:
  • 9.9 (95% CI, 6.3-30) for ages 1-35 years, and
  • 9.2 (95% CI, 6.6-12.7) for ages 36-49 years.
• For type 2, those numbers were:
  • 6.1 (95% CI, 2.2-34.5) for ages 21-35 years, and
  • 4.7 (95% CI, 3.2-6.9) for ages 36-49 years.

Limitations

• Retrospective.
• Most nonautopsied cases assumed to be cardiac-related.
• No laboratory, lifestyle data.