Diabetes mortality statistics in the United States
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National Diabetes Mortality Statistics in the United States
Recent research shows that diabetes is a major contributor to mortality in the United States, accounting for a much larger share of deaths than what is typically reported on death certificates. Estimates suggest that about 11.5% to 11.8% of all deaths among adults aged 30–84 are attributable to diabetes, which is significantly higher than the 3.3–3.7% of deaths where diabetes is listed as the underlying cause on death certificates Stokes2017Alva2018Rodriguez2019. In 2018, this translated to approximately 293,224 diabetes-attributable deaths nationwide, with cardiovascular disease (CVD) accounting for about 90,953 of these deaths .
Trends in Diabetes Mortality Rates
Over the past two decades, age-standardized diabetes mortality rates in the U.S. have generally declined, dropping from 28.1 deaths per 100,000 in 2000 to 19.1 per 100,000 in 2019 . All-cause death rates among adults with diabetes have decreased by about 20% every 10 years, with even greater declines in deaths from vascular causes (32% per decade) and cancer (16% per decade) . However, the decline in diabetes mortality has slowed or plateaued in recent years, especially after 2014 Kim2019Waqas2025.
Geographic and Demographic Disparities in Diabetes Mortality
Urban vs. Rural Differences
Diabetes mortality rates have decreased significantly in urban areas but have remained largely unchanged or even increased in rural areas, particularly in the rural South Kobo2022Callaghan2020. The age-adjusted mortality rate (AAMR) for diabetes is consistently higher in rural areas compared to urban ones. While urban areas saw a decrease in diabetes-related mortality as both an underlying and contributing cause of death, rural areas experienced little to no improvement, and in some cases, rates increased Kobo2022Callaghan2020.
Racial and Ethnic Disparities
There are substantial racial and ethnic disparities in diabetes mortality. In 2019, the highest national-level diabetes mortality rates were observed among American Indian or Alaska Native (AIAN) populations (35.6 per 100,000), followed by Black (31.9), Latino (19.7), White (17.6), and Asian (12.6) populations . These disparities persist across counties, with the AIAN population experiencing the greatest variation in mortality rates . Declines in mortality rates have occurred for most groups, but the pace and extent of improvement vary widely by race, ethnicity, and location Kobo2022Nassereldine2025.
Years of Life Lost and Underestimation of Diabetes Mortality
Diabetes leads to a significant loss of life expectancy, with an average of 4.4 years of life lost per person with diabetes . Traditional methods that only count deaths where diabetes is the underlying cause greatly underestimate the true impact of diabetes on mortality. Using a multiple-cause-of-death approach provides a more accurate picture, showing that diabetes is involved in a much larger proportion of deaths, often in combination with other conditions like cardiovascular disease and hypertension Stokes2017Alva2018Rodriguez2019.
Shifting Causes of Death Among People with Diabetes
While cardiovascular disease remains the leading cause of death among people with diabetes, its share has declined over time, and deaths from other causes, such as hypertension, hypertensive renal disease, and non-vascular, non-cancer causes, have become more common Gregg2018Rodriguez2019. The proportion of deaths from vascular causes among adults with diabetes dropped from nearly 48% in the late 1980s to about 34% in the mid-2010s, while non-vascular, non-cancer causes increased .
Conclusion
Diabetes remains a leading cause of death in the United States, with its true impact on mortality often underestimated. While overall diabetes mortality rates have declined, significant disparities persist by geography, race, ethnicity, and rurality. Continued efforts are needed to address these disparities and to more accurately track and reduce the burden of diabetes-related deaths across all communities Stokes2017Alva2018Kim2019+5 MORE.
Sources and full results
Most relevant research papers on this topic
CDC WONDER: Trends in diabetes mellitus mortality in the United States from 1968 to 2021.
U.S. diabetes mortality rates fluctuated from 1968 to 2019, with a decline halted between 2010 and 2019, and racial disparities were evident, with higher rates in the Black population.
Diabetes-attributable mortality in the United States from 2003 to 2016 using a multiple-cause-of-death approach.
Using a multiple-cause-of-death approach, we can better understand diabetes' contribution to mortality in the United States from 2003 to 2016.
Urban–rural disparities in diabetes-related mortality in the USA 1999–2019
Urban areas experienced a decrease in diabetes-related mortality between 1999 and 2019, mainly among females and older patients, while rural areas saw a higher rate.
The Burden of Diabetes Mortality by County, Race, and Ethnicity in the U.S., 2000–2019
Diabetes mortality rates in the U.S. decreased from 2000 to 2019, but remain high for many Americans, with disparities across racial and ethnic populations.
The Changing Landscape of Diabetes Mortality in the United States Across Region and Rurality, 1999-2016.
Diabetes mortality has declined in the US over the past 2 decades, but improvements vary by place, with rural areas and the rural South lagging behind, highlighting the need for targeted interventions in these areas.
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