Finnish people with diabetes have a low incidence of renal failure

Between 1965 and 1999, 20 005 Finnish children and adults were diagnosed as having type 1 diabetes. During a follow-up period lasting up to 35 years, 632 of them developed end stage renal failure—an overall incidence of only 2.2% at 20 years and 7.8% at 30 years after diagnosis. A study linking three national Finnish registers (one for diabetes, one for renal failure, and one for death) found that risk of end stage renal failure was virtually zero for the first 15 years after diagnosis, rose rapidly between 15 and 20 years, then reached a plateau for the 15 years after that. Children who were diagnosed as having type 1 diabetes before the age of 5 had the best prognosis; only 3% of them developed end stage renal failure during the ensuing 30 years.

These estimates indicate that the outlook for patients with type 1 diabetes is better than previously thought, especially for the under 5s. Prognosis improved steadily throughout the study (which ran up to 2001), indicating that diabetes is now less of a threat to renal function than it has ever been. Survival also improved; people who developed diabetes in the late 1970s were half as likely to die during the study as people diagnosed in the late 1960s (relative risk 0.52, 95% CI 0.44 to 0.61).

JAMA 2005;294: 1782-7

Older Americans have healthier serum lipids despite the obesity epidemic

Serum concentrations of total cholesterol have been declining in US adults since the 1960s, and the trend continues, according to the latest look at data from serial national surveys. Between 1988 and 2002, total cholesterol levels among adults over 20 fell from 5.34 mmol/l to 5.26 mmol/l (P = 0.009), with the biggest decreases in women over 50 and men over 60. During the same period, the percentage of adults with total cholesterol of at least …