Gemma Rojo Martínez
Senior researcher and group leader at CIBER for Diabetes and Associated Metabolic Diseases (CIBERDEM), researcher at the Regional University Hospital of Malaga and at IBIMA-Bionand platform
In general, the population-based approach of this study makes it extremely robust: there is no sampling; the entire population of a whole country is used to extract results.
The main limitations are inherent in the design; causality cannot be proven, and results based on medical records always have the inaccuracy of the cause of death, even of the accurate diagnosis of the diseases investigated. Perhaps most importantly, the data are from about 15 years ago, when certain cardioprotective drugs for diabetes (sodium-glucose cotransporter 2 inhibitors, or SGLT2 inhibitors) were not yet in use, although they are widely used today.
In any case, the study highlights the need for surveillance and prevention of SCD [sudden cardiac death] in young patients with diabetes.