Self-reported diabetes and mortality in a prospective Chinese elderly cohort study in Hong Kong

Objective: In Western countries, diabetes mellitus is positively associated with death from all- and specific-causes including cancer, cardiovascular and respiratory diseases. In a Chinese setting with a different disease pattern: high diabetes rates in a relatively non-obese population with low ischemic heart disease (IHD) rates where diabetes is positively associated with IHD, we examined the association of self-reported diabetes with death among older people. Methods: Multivariable Cox regression analysis was used in a population-based prospective cohort of 66,820 Chinese (65. + years) enrolled from July 1998 to December 2001 at Elderly Health Centers of the Hong Kong Government Department of Health, followed until May 31, 2012. Results: During 10.9. years of follow-up, 19,845 deaths occurred. Self-reported diabetes was associated with death from all-causes (hazard ratio (HR) = 1.56, 95% confidence interval (CI) 1.51, 1.62), cardiovascular disease (HR = 1.84, 95% CI 1.72, 1.96), cancer (HR. =. 1.11, 95% CI 1.03 to 1.20), liver cancer (HR. =. 1.38, 95% CI 1.13 to 1.69) and stomach cancer (HR. =. 1.38, 95% CI 1.03 to 1.85), adjusted for age, sex, socio-economic position, alcohol use, smoking, exercise and body mass index. Conclusion: Such a pattern of associations suggests that further investigation into the drivers of diabetes is required in this and similar populations.