Furthermore, information on differences in risk of SCD between persons with DM type 1 (DM1) and 2 (DM2) is scarce. As autopsy is far from always conducted, there is a potential bias in the reported results. 2, 6, 7, 9 However, these studies do not include young persons or are based on findings from one region of a country with data almost exclusively obtained from autopsied decedents.
5 Previous studies report a two- to four-fold increased risk of SCD in persons with DM after adjustment for cardiovascular risk factors. 5 Increased arrhythmogenic potential, occurring as a result of diabetes-related autonomic neuropathy may be another contributing factor. 2, 5, 6 These include manifest and silent myocardial ischaemia, QT interval prolongation, hypoglycaemia, diabetic cardiomyopathy, and decreased ventilatory response to hypoxia and hypercapnia. 1–3, 5–9ĭiabetes mellitus is a well-established risk factor of SCD and several mechanisms have been proposed to account for the increased risk of SCD among persons with DM. 1–5 The decreased life expectancy is in part explained by an increased risk of cardiovascular disease and sudden cardiac death (SCD) among patients with DM (SCD-DM). 1 Persons with DM have increased all-cause mortality compared to the general population. See page 2707 for the editorial comment on this article (doi: 10.1093/eurheartj/ehaa011) Introductionĭiabetes mellitus (DM) is one of the most common chronic diseases in the young. Sudden cardiac death, Diabetes, Children, Young Within the age range 36–49 years, the IR among persons with DM was 119.8 per 100 000 person-years compared to 19.7 per 100 000 person-years among persons without DM (IR ratio 6.1, 95% CI 4.7–7.8). Among those aged 1–35 years, the IR of SCD-DM was 21.9 per 100 000 person-years compared to 2.6 per 100 000 person-years among persons without DM. Among the 14 294 decedents, there were 669 with DM, of which 118 suffered SCD (9% of all SCD), making SCD the leading cause of death among young persons with DM. The Danish Register of Medicinal Product Statistics was used to identify persons with type 1 DM and type 2 DM. Through review of autopsy reports, discharge summaries, and the Danish registries, we identified 1363 cases of SCD. By using the highly descriptive Danish death certificates, 1698 cases of sudden and unexpected death were identified. All 14 294 deaths in the 10-year period were included. The study population consisted of all persons in Denmark aged 1–49 years in 2000–09, which equals 27.1 million person-years.
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