Diabetes mortality rate
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Global Diabetes Mortality Rate: Prevalence and Regional Differences
Diabetes is a major contributor to global mortality. In 2019, it was estimated that 4.2 million deaths among adults aged 20–79 years were attributable to diabetes, accounting for about 11.3% of all deaths in this age group worldwide. The proportion of deaths due to diabetes varies by region, from 6.8% in Africa to 16.2% in the Middle East and North Africa. Notably, nearly half of these deaths occurred in people under 60 years old, with the highest proportion of early deaths in Africa (73.1%) and the lowest in Europe (31.4%) . Earlier estimates for 2010 and 2013 showed diabetes accounted for 6.8% and 8.4% of global deaths, respectively, with the burden being higher in women and in countries with large populations such as China, India, and the United States Roglić2009Group2015.
Trends in Diabetes Mortality: Declines and Persistent Challenges
All-Cause Mortality Trends in Diabetes
Recent decades have seen a decline in all-cause mortality rates among people with diabetes, especially in high-income and predominantly Europid populations. Between 2000 and 2016, 74% of studied populations with diabetes experienced decreasing mortality rates, with the annual reduction in mortality matching or exceeding that of people without diabetes in nearly 60% of populations . In the United States, all-cause death rates among adults with diabetes declined by 20% every 10 years from 1988–94 to 2010–15, with even greater declines in deaths from vascular causes (32% per decade) . Similar trends were observed in Canada and the UK, where the excess risk of mortality for people with diabetes compared to those without diabetes decreased significantly from 1996 to 2009 .
Age, Sex, and Ethnic Differences
Mortality rates remain higher for males and older individuals with diabetes, but the rate of decline in mortality is generally consistent across age and sex groups. However, the relative risk of death compared to the non-diabetic population is higher in females and peaks at ages 40–70 years . Declines in mortality have been less consistent in younger age groups and non-Europid populations .
Diabetes Mortality in Younger Populations
Among people under 25 years old, diabetes mortality remains a significant concern, particularly in low and low-middle income countries. In 2019, the global age-standardized death rate for diabetes in this age group was 0.50 per 100,000 population, with 73.7% of these deaths due to type 1 diabetes. Most deaths occurred in countries with lower socio-demographic indices, and the decline in mortality rates over the past three decades has been slowest in these regions . In high-income countries, there is still a significant excess mortality among young people with type 1 diabetes, with a standardized mortality ratio of 2.15 compared to the general population .
Excess Mortality and Risk Factors in Type 2 Diabetes
People with type 2 diabetes have a higher risk of death from any cause and from cardiovascular causes compared to the general population. The excess risk is greater in younger patients, those with poor glycemic control, and those with more severe renal complications. For example, patients under 55 years old with good glycemic control still had a nearly doubled risk of death compared to controls, while the risk was lower in older patients .
Shifting Causes of Death in Diabetes
While vascular disease has historically been the leading cause of death among people with diabetes, its proportion has declined over time due to improved management. In the US, the proportion of deaths from vascular causes among adults with diabetes dropped from 47.8% in 1988–94 to 34.1% in 2010–15, while deaths from non-vascular, non-cancer causes increased . The proportion of deaths from cancer remained relatively stable.
Conclusion
Diabetes remains a leading cause of mortality worldwide, responsible for about one in nine deaths among adults aged 20–79 years. While mortality rates among people with diabetes have declined in many regions, especially in high-income countries, significant disparities persist by age, sex, ethnicity, and region. The burden of diabetes mortality is shifting, with a growing proportion of deaths occurring at younger ages in low- and middle-income countries and a diversification of causes of death. Continued investment in diabetes prevention, early diagnosis, and improved management is essential to further reduce the global mortality burden of diabetes Roglić2009Group2015Cousin2022+7 MORE.
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