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Diabetes-Related Mortality in the United States: An Overview

Diabetes Mortality Rates and Trends

Diabetes is a significant contributor to mortality in the United States, with recent studies indicating that its impact is often underestimated. Research using data from the National Health Interview Survey (NHIS) and the National Health and Nutrition Examination Survey (NHANES) has shown that diabetes accounts for approximately 11.5% to 11.8% of all deaths among adults aged 30-84 years. This figure is substantially higher than the 3.3% to 3.7% of deaths where diabetes is listed as the underlying cause on death certificates, suggesting that the true burden of diabetes on mortality is underreported.

State-Level Variations in Diabetes Mortality

State-level analyses reveal significant variations in diabetes-attributable deaths across the United States. The total number of diabetes-attributable deaths ranges from 415 in Alaska to 28,538 in California, with cardiovascular disease (CVD) deaths ranging from 113 in Alaska to 8,908 in California. The average diabetes-attributable death rate per 100,000 people is 125 for males and 105 for females for all-cause deaths, and 40 for males and 31 for females for CVD deaths. These variations are largely influenced by state population sizes and diabetes prevalence rates.

Historical and Recent Trends in Diabetes Mortality

Historical data indicate that diabetes-related mortality has been a persistent issue. For instance, in 1955, the death rate due to diabetes was 15.3 per 100,000, slightly lower than the previous year. More recent data from 1985 to 2015 show a significant decline in all-cause death rates among adults with diabetes, decreasing by 20% every 10 years. This decline is more pronounced for vascular causes, which decreased by 32% every 10 years, and cancer-related deaths, which decreased by 16% every 10 years.

Diabetes as a Contributing Cause of Death

The determination of diabetes as an underlying cause of death often leads to an underestimation of its impact. From 2007 to 2017, age-standardized mortality rates for diabetes as an underlying or contributing cause of death were 32.2 and 75.7 per 100,000 individuals, respectively. The overall age-standardized mortality rate for individuals with diabetes listed on death certificates was 105.1 per 100,000 during this period. These figures highlight the importance of considering diabetes as a contributing factor in mortality statistics.

Global Perspective and Future Projections

Globally, diabetes is estimated to have caused 2.9 million excess deaths in the year 2000, accounting for 5.2% of all deaths. In the United States, projections indicate that the number of people with diagnosed diabetes will increase to 48.3 million by 2050, up from previous estimates of 39 million. This increase is attributed to rising diabetes incidence and declining relative risk of death among people with diabetes.

Conclusion

Diabetes significantly contributes to mortality in the United States, with its impact often underestimated in official statistics. State-level variations and historical trends underscore the need for targeted public health interventions. Accurate data collection and comprehensive reporting are essential for better monitoring and addressing the diabetes epidemic. As the prevalence of diabetes continues to rise, understanding its full impact on mortality is crucial for effective healthcare planning and intervention.