ESRD Decreases in Type 1 Diabetes

The rate of end-stage renal disease (ESRD)for patients with type 1 diabetes is lower thanwas originally thought. Furthermore, the risk ofdying from type 1 diabetes during the first 20 to30 years after diagnosis has dropped by 50%,according to the results of a Finnish studyreported in the Journal of the American MedicalAssociation (October 12, 2005).

Earlier estimates forecast that 1 in 5 patientswith the disease would develop ESRD sometimeduring the first 20 years following diagnosis.The new study found, however, that the numberis closer to 1 in 50 after 20 years and about 1 in12 after 30 years of having the disease. For thestudy, the researchers examined the records of>20,000 Finnish patients diagnosed with type 1diabetes between 1965 and 1969. All of thepatients were under 30 when diagnosed, andthey were included in the Finnish Diabetes Register.The participants were followed until theydeveloped ESRD or died or until the studyended on December 31, 2001.

The rate of ESRD was only 2.2% after 20years of diabetes, compared with earlier estimatesof 20%. After 3 decades, the rate was7.8%. The risk of death fell by 59% from thebeginning of the study (1965-1969) to near theend (1980-1999). Generally, 6.8% of the individualsdied during the first 20 years, and 15%died at some point during the 30 years afterdiagnosis. A majority of the deaths occurredamong the patients who never developedESRD, reported the investigators.