Death rate from diabetes

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Death Rate from Diabetes: A Global Perspective

Global Mortality Attributable to Diabetes

Diabetes is a significant contributor to global mortality, particularly among adults aged 20-79 years. In 2019, it was estimated that 4.2 million deaths in this age group were attributable to diabetes, accounting for 11.3% of global deaths. The impact of diabetes on mortality varies by region, with the highest proportion of deaths occurring in the Middle East and North Africa (16.2%) and the lowest in the Africa Region (6.8%). Notably, nearly half of these deaths (46.2%) occur in individuals under 60 years of age, with the Africa Region experiencing the highest proportion of such deaths (73.1%).

Trends in All-Cause Mortality Among People with Diabetes

Over recent decades, there has been a notable decline in all-cause mortality rates among people with diabetes. Between 2000 and 2016, mortality rates decreased in 74% of the studied populations, with significant reductions observed in predominantly Europid populations and older age groups. This decline in mortality rates among people with diabetes has been more pronounced than in those without diabetes, particularly for all-cause and vascular-related deaths. However, the patterns of mortality reduction are less clear in younger age groups and non-Europid populations.

Mortality Rates in Clinical Trials of Type 2 Diabetes

Randomized controlled trials (RCTs) of type 2 diabetes have shown substantial variability in mortality rates, ranging from 0.28 to 8.24 per 100 patient-years. Higher mortality rates are often associated with older age, longer duration of diabetes, and the presence of comorbid conditions such as hypertension and chronic kidney disease. These findings highlight the importance of considering patient characteristics when interpreting mortality data from clinical trials.

Cause-Specific Mortality Trends in the USA

In the USA, all-cause mortality rates among adults with diabetes have declined significantly from 1988-94 to 2010-15, with a 20% reduction every 10 years. Vascular-related deaths decreased by 32%, cancer-related deaths by 16%, and non-vascular, non-cancer deaths by 8% over the same period. Despite these improvements, the proportion of deaths from non-vascular, non-cancer causes has increased, indicating a shift in the causes of death among people with diabetes.

Mortality Estimates for 2013

In 2013, diabetes was estimated to account for 8.4% of all-cause deaths among adults aged 20-79 years, translating to approximately 5.1 million deaths globally. The highest rates of diabetes-attributable mortality were observed in South-East Asian women aged 50-59 years, and the largest number of deaths occurred in countries with large populations such as China, India, and the USA. This underscores the global burden of diabetes and the need for targeted interventions in high-prevalence regions.

Long-Term Trends in Sweden

In Sweden, from 1998 to 2014, there was a substantial decline in mortality and cardiovascular outcomes among people with both type 1 and type 2 diabetes. The reduction in cardiovascular outcomes was more pronounced in patients with type 1 diabetes compared to controls, while patients with type 2 diabetes experienced smaller reductions in fatal outcomes than controls. This suggests that while overall mortality has improved, there are still disparities in outcomes based on diabetes type and other factors.

Mortality Trends in England

In England, from 2001 to 2018, total mortality among people with diabetes declined by 32% in men and 31% in women. This decline was similar to that observed in individuals without diabetes, maintaining the mortality gap between the two groups. The reduction in vascular disease deaths has led to a shift in the leading causes of death from vascular diseases to cancers among people with diabetes. This transition highlights the evolving nature of diabetes-related mortality and the need for comprehensive management strategies.

Conclusion

Diabetes remains a major contributor to global mortality, with significant regional variations and a substantial impact on younger populations. While there have been notable improvements in mortality rates among people with diabetes, particularly in high-income countries, disparities persist based on age, ethnicity, and comorbid conditions. Continued efforts in diabetes prevention, management, and data collection are essential to further reduce the mortality burden and address the evolving causes of death in this population.