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These studies suggest that diabetes can lead to death through cardiovascular disease, cancer, infections, and renal complications, with varying risks based on age, glycemic control, and other health factors.
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Diabetes is a significant global health issue, contributing to a substantial number of deaths annually. Understanding how diabetes leads to mortality involves examining the various complications and conditions associated with the disease. This article synthesizes research findings to provide a comprehensive overview of the primary causes of death in individuals with diabetes.
Cardiovascular disease (CVD) is one of the leading causes of death among individuals with diabetes. Studies have shown that people with diabetes have a significantly higher risk of dying from cardiovascular causes compared to those without diabetes . The excess risk is particularly pronounced in younger individuals and those with poor glycemic control and severe renal complications.
For instance, a study from the Swedish National Diabetes Register indicated that the rate of cardiovascular death was 7.9% among patients with diabetes, compared to 6.1% in the general population. Another study highlighted that diabetes increased the risk of cardiovascular death by more than twofold in both men and women.
Renal failure is another critical complication that contributes to the high mortality rate in diabetic patients. Poor glycemic control exacerbates the risk of renal complications, which in turn increases the likelihood of death .
The risk of death from renal disease is particularly high in patients with long-standing diabetes and those with nephropathy. For example, a Japanese study found that poorer glycemic control was associated with a reduced lifespan, especially in patients with nephropathy.
Diabetes is also associated with an increased risk of death from several types of cancer. Research has shown that individuals with diabetes have a higher likelihood of dying from cancers of the liver, pancreas, ovary, colorectum, lung, bladder, and breast .
A comprehensive study involving over 820,000 participants found that diabetes increased the risk of cancer death by 25%. This association underscores the need for vigilant cancer screening and management in diabetic patients.
Infections, particularly pneumonia, are a significant cause of death in diabetic patients, especially among the elderly. The immune system's compromised state in individuals with diabetes makes them more susceptible to severe infections.
The incidence of death due to infections increases with age. For example, 80.7% of pneumonia-related deaths in diabetic patients were observed in those over the age of 70.
Diabetes is also linked to an increased risk of death from non-vascular causes such as liver disease, mental disorders, and chronic obstructive pulmonary disease (COPD) . Additionally, there is a notable association between diabetes and deaths from external causes, including intentional self-harm.
A competing risks analysis revealed that diabetes significantly increases the risk of death from cardiovascular, cancer, and non-cardiovascular non-cancer causes, with hazard ratios indicating a higher mortality risk across these categories.
Diabetes significantly contributes to mortality through various complications, primarily cardiovascular disease, renal failure, cancer, and infections. Effective management of glycemic control and regular monitoring for associated conditions are crucial in reducing the mortality risk in diabetic patients. Understanding these risks can help healthcare providers develop better strategies for managing diabetes and improving patient outcomes.
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