Diabetes and Metabolism Journal

Korean Diabetes Association (대한당뇨병학회)
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Cause-of-Death Trends for Diabetes Mellitus over 10 Years

제2형 당뇨병환자의 사망원인에 대한 10년간의 추세 변화 -부산 시내 6개 종합병원을 중심으로-

Park, Su-Kyung;Park, Mi-Kyoung;Suk, Ji-Hye;Kim, Mi-Kyung;Kim, Yong-Ki;Kim, In-Ju;Kang, Yang-Ho;Lee, Kwang-Jae;Lee, Hyun-Seung;Lee, Chang-Won;Kim, Bo-Hyun;Lee, Kyung-Il;Kim, Mi-Kyoung;Kim, Duk-Kyu
박수경;박미경;석지혜;김미경;김용기;김인주;강양호;이광재;이현승;이창원;김보현;이경일;김미경;김덕규

  • Published : 20090200
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Abstract

Background: Recently, diabetic mortality is lower than ever before, likely due to dramatic improvements in diabetes care. This study set to analyze changes in the cause of death in type 2 diabetes mellitus (T2DM)in the past 10 years. Methods: All subjects were T2DM patients over the age of 30 whose death certificates were issued at six hospitals in the Busan metropolitan area from 2000 to 2004. The patients were excluded if they had been clinically diagnosed with significant tuberculosis, liver, thyroid, renal, connective tissue diseases and cancers, prior to T2DM diagnosis. We classified the cause of death into several groups by KCD-4. The results were compared with published data on the period from 1990 to 1994. Results: The study comprised 680 patients, of which 374 (55.0%) were male. The average age of death was 66.3 $\pm$ 10.7 years. The most common cause of death was cardiovascular disease (30.6%), followed by infectious disease (25.3%), cancer (21.9%), congestive heart failure (7.1%), renal disease (4.7%), liver disease (2.7%), and T2DM itself (1.9%). In the study from the earlier period, the most common cause of death was also cardiovascular disease (37.6%), followed by infectious disease (24.2%), T2DM (6.0%), liver disease (5.4%),cancer (4.7%), and renal disease (3.3%). Conclusion: Over both study periods, the first and second cause of death in T2DM were cardiovascular disease and infectious disease, respectively. However, death by cerebral infarction among cardiovascular disease patients was significantly lower in the latter period, while death by malignancy was markedly increased.

연구배경: 당뇨병의 유병률은 세계적으로 계속 증가하고 있다. 지난 10년 사이에 새로운 당뇨 치료제들이 임상에 도입되었고, 당뇨관리 기술도 비약적으로 발달하였기에 당뇨병으로 인한 이환과 사망에 변화가 있을 것으로 가정해 볼 수 있다. 본 연구는 지난 10년 동안 제2형 당뇨병환자들에서 사망 원인에 추세 변화가 있는지 확인하고자 하였다. 방법: 10년간의 추세 변화를 보기 위해 1990년부터 1994년 동안 사망 원인을 조사한 연구 결과를 비교 대상으로 하였다. 2000년부터 2004년까지 부산 시내의 주요 6개 병원에서 사망 진단서가 발부된 30세 이상의 제2형 당뇨병환자를 연구 대상으로 하였다. 당뇨병 진단 당시에 결핵, 간질환, 갑상선질환, 신장질환, 결체 조직질환, 악성 종양 등이 동반된 경우는 제외하였다. 사망 원인은 직접 사인으로 기재된 질환으로 하였고, 한국표준질병사인분류표(KDC-4)에 따라분류하였다. 결과: 연구 대상은 총 680명이었으며, 이 중 374명이 남성이었다. 평균 사망 연령은 66.3 $\pm$ 10.7세였다. 사망 원인은 심혈관질환(30.6%) {뇌혈관질환(15.0%), 허혈성 심질환(15.6%)}이었고, 그 다음은 감염성질환(25.3%), 악성 종양(21.9%), 울혈성 심부전(7.1%), 신질환(4.7%), 간질환(2.7%), 당뇨병 관련 질환(1.9%) 순이었다. 결론: 2000년대에 제2형 당뇨병환자에서 주된 사망 원인은 1990년대와 마찬가지로 심혈관질환과 감염성질환이었다. 그러나, 심혈관질환 중 뇌경색으로 인한 사망 비율은 상당히 감소한 반면, 악성질환의 비율은 크게 증가하여 사망 원인 중 3위를 차지하였다.

Keywords

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