Type 2 diabetes is one of the most common chronic diseases in the U.S.; however, few studies have comprehensively assessed the relations between its comorbidities and premature death. Prospective analyses were performed linking data from National Health Interview Surveys (1997 to 2009) to National Death Index records (2011) among 366,971 adults. Cox models were used to test the relations of diabetes and eleven comorbidities with all-cause, CVD, or cancer mortality. After a median follow-up of 8.0 years (2.9 million person-years), a total of 38,687 participants had died. Compared with common-conditions-free subjects, we ranked hazard ratios (HR[95% CI]) of eleven diabetic comorbidities, and the top three were chronic kidney disease (CKD: 5.3[4.9-5.7]), liver cirrhosis (5.1[4.6-5.8]), and blindness (4.4[3.8-5.1]) for all-cause mortality. Diabetics with CKD (5.9[5.0-6.9]) and blindness (5.0[3.8-6.5]) were at the highest risk for CVD deaths. Comorbid cancer (4.1[3.6-4.6]), liver cirrhosis (4.1[3.2-5.2]), and hepatitis (2.7[2.1-3.5]) ranked top three for cancer mortality. Diabetes comorbidities may substantially increase the risk of all-cause, CVD, or cancer mortality. Liver disease is more strongly related to cancer mortality, whereas CKD and blindness with CVD. Recognition of these associations may assist with more appropriate and effective screening programs that may help decrease associated mortality.


D. Sun: None. T. Zhou: None. X. Li: None. Y. Heianza: None. X. Shang: None. V. Fonseca: Consultant; Self; Abbott. Board Member; Self; American Association of Clinical Endocrinologists. Consultant; Self; Eli Lilly and Company. Stock/Shareholder; Self; Amgen Inc.. Consultant; Self; Asahi Kasei Corporation, AstraZeneca, Novo Nordisk Inc., ADOCIA, Intarcia Therapeutics, Inc., Sanofi-Aventis. L. Qi: None.

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