American journal of epidemiology
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There is concern that the increasing prevalence of type 2 diabetes may diminish improving trends in life expectancy. This study aimed to determine whether the mortality of type 2 diabetes, relative to mortality in the general population, is remaining constant. The study included a cohort of 48,556 subjects with type 2 diabetes first diagnosed between 1996 and 2006, drawn from 197 family practices in the United Kingdom General Practice Research Database. ⋯ After adjustment for age, sex, and diabetes duration, there was a consistent decrease in relative mortality during the period of study. Relative mortality for subjects diagnosed in 1996 was 13% (95% CI: 2, 25) higher than that in 2001; for subjects diagnosed in 2006, relative mortality was 26% (95% CI: 8, 40) lower than that in 2001. Relative mortality of type 2 diabetes appears to be decreasing in men and women in the United Kingdom.
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In 1976, the national swine influenza vaccination program in the United States was suspended because of an increased risk of Guillain-Barré syndrome. Subsequent studies of seasonal influenza vaccine have given conflicting results. The authors used the self-controlled case series method to investigate the relation of Guillain-Barré syndrome with influenza vaccine and influenzalike illness using cases recorded in the General Practice Research Database from 1990 to 2005 in the United Kingdom. ⋯ The relative incidence was similar (0.89, 95% confidence interval: 0.42, 1.89) when the analysis was restricted to a subset of validated cases. The authors found no evidence of an increased risk of Guillain-Barré syndrome after seasonal influenza vaccine. The finding of a greatly increased risk after influenzalike illness is consistent with anecdotal reports of a preceding respiratory illness in Guillain-Barré syndrome and has important implications for the risk/benefit assessment that would be carried out should pandemic vaccines be deployed in the future.