@Boerenkool, great studies. The second one is particularly focused on younger people due to its population selection. Some excerpts:
Increased mortality in diabetes during the first 10 years of the disease. A population‐based study (DISS) in Swedish adults 15–34 years old at diagnosis.
Fifty‐eight patients died, corresponding to an SMR of 3.5 (CI=2.7–4.5), which increased from 1.5 at 15–19 years to 4.1 at 30–34 years. […] Evidence of alcohol or drug misuse, mental dysfunction or suicide was found in 40 of all 58 deceased cases. Less often, hypoglycaemia ( n =7) or hyperglycaemia‐ketoacidosis ( n =11) was present at death. Unexplained ‘dead in bed’ was found once.
Conclusions. In the investigated population‐based cohort the early mortality was about threefold increased. Hypoglycaemia and ketoacidosis per se played a relatively small role compared with a heavy impact from social and mental dysfunction, and from careless use of alcohol or drugs.
This study, then, looks at PWDs who were 15-34 at diagnosis and follows them for 10 years.
- Mortality for this cohort is 3.5 times higher than an average cohort
- Alcohol abuse appears to be a significant cause of death for 19 of the 58 deaths (“According to the clinical records […] acute alcohol intoxication and/or chronic abuse had been of importance in […] 19 cases”) but with a contributive cause in more than that.
- Depression was the cause for 8 deaths (Table 4) of 58, and may have been involved in 8 others (drug deaths, also Table 4), since drug use is one of the possible complications of depression. In addition, some of the alcohol deaths may also have been linked to depression
- Deaths from diabetes-related causes were surprisingly low, considering: 7 (or 8 depending upon interpretation) linked to hypoglycemia, and 11 linked to DKA—but you have to be careful of that number, because these do not appear independent from the ones listed above (alcohol for instance).
Another fact I noted—when you look at the specific stats for T1Ds in the tables, the mortality is totally skewed to the 18-34 age groups, and much lower afterwards: 24 deaths between 18-34, and 2 between 35-41. It peaks sharply between 25-29 (11 deaths).