Death from diabetes
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Death from Diabetes: A Comprehensive Analysis
Diabetes and All-Cause Mortality
Diabetes significantly increases the risk of death from various causes. A large-scale study involving 820,900 individuals found that diabetes nearly doubles the risk of death from any cause, with a hazard ratio of 1.80 compared to non-diabetics. This increased risk is consistent across different age groups and is influenced by factors such as glycemic control and the presence of renal complications.
Global Mortality Rates Attributable to Diabetes
In 2019, diabetes was responsible for approximately 4.2 million deaths among adults aged 20-79 years, accounting for 11.3% of global deaths in this age group. The impact of diabetes on mortality varies by region, with the highest proportion of diabetes-attributable deaths occurring in the Middle East and North Africa (16.2%) and the lowest in Africa (6.8%). Notably, nearly half of these deaths occur in individuals under the age of 60, highlighting the premature mortality associated with diabetes.
Cause-Specific Mortality in Diabetics
Cardiovascular and Vascular Diseases
Cardiovascular diseases are a leading cause of death among diabetics. Studies show that individuals with diabetes have a significantly higher risk of death from cardiovascular causes, with hazard ratios ranging from 1.14 to 2.32 depending on the study and population . In Japan, vascular diseases accounted for 14.9% of deaths among diabetics, with ischemic heart diseases and cerebrovascular diseases being prominent contributors.
Cancer
Diabetes is also associated with an increased risk of death from various cancers. The risk is moderately elevated for cancers of the liver, pancreas, ovary, colorectum, lung, bladder, and breast. In a Spanish cohort, diabetes increased the risk of cancer death by 37% in men and 68% in women.
Infectious Diseases and Other Non-Vascular Causes
Infectious diseases, particularly pneumonia, are a significant cause of death among diabetics, especially in older age groups. Diabetes also increases the risk of death from renal disease, liver disease, mental disorders, and chronic obstructive pulmonary disease . In Mexico City, diabetes was associated with a high rate of death from renal disease, cardiac disease, and infections, reflecting poor glycemic control and limited access to medical care.
Trends in Mortality Over Time
Recent trends indicate a decline in all-cause mortality rates among diabetics in the USA, with a 20% reduction every 10 years from 1988 to 2015. This decline is more pronounced for vascular causes, which decreased by 32% every 10 years, and cancer deaths, which decreased by 16%. However, the proportion of deaths from non-vascular, non-cancer causes has increased, suggesting a diversification in the causes of death among diabetics.
Conclusion
Diabetes significantly increases the risk of premature death from a variety of causes, including cardiovascular diseases, cancers, and infectious diseases. While global mortality rates attributable to diabetes are high, regional variations and trends over time highlight the importance of targeted prevention and management strategies. Improved glycemic control and access to comprehensive medical care are essential to reduce the mortality burden associated with diabetes.
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