Mortality causes in diabetes

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All-Cause Mortality in Diabetes

People with diabetes have a higher risk of dying from any cause compared to those without diabetes. This increased risk is seen in both type 1 and type 2 diabetes, and is especially pronounced in younger individuals and those with poor glycemic control or kidney complications Li2019Moss1991Tancredi2015+7 MORE. In some populations, diabetes can account for up to one third of all deaths in middle-aged adults .

Cardiovascular Disease Mortality in Diabetes

Cardiovascular diseases, including heart disease and stroke, are the leading causes of death among people with diabetes. The risk of dying from cardiovascular causes is several times higher in people with diabetes than in those without, with studies showing up to an eight-fold increase in young adults and a two- to four-fold increase in older adults Li2019Moss1991Tancredi2015+7 MORE. Good glycemic control and management of cardiovascular risk factors can reduce this risk, but it remains elevated compared to the general population Tancredi2015Rawshani2017Raghavan2019.

Renal Disease and Kidney-Related Mortality

Diabetes is a major cause of kidney disease, and deaths from renal complications are significantly higher in people with diabetes. In some studies, the risk of dying from kidney disease is more than 20 times higher in people with diabetes compared to those without Li2019Moss1991Alegre-Díaz2016+1 MORE. This is especially true in populations with poor glycemic control and limited access to medical care .

Respiratory Disease, Infection, and Other Causes

People with diabetes also have an increased risk of dying from chronic lower respiratory diseases, influenza, pneumonia, and infections. The risk of death from these causes is higher than in the general population, though not as high as for cardiovascular or kidney diseases Li2019Moss1991Alegre-Díaz2016+1 MORE. Infections are a particularly important cause of death in settings where diabetes management is poor .

Cancer Mortality in Diabetes

The relationship between diabetes and cancer mortality is less clear. Some studies show no significant increase in cancer-related deaths among people with diabetes, while others report a modest increase Li2019Gregg2018Alegre-Díaz2016. The proportion of deaths from cancer among people with diabetes has remained relatively stable over time .

Trends and Changes in Mortality Causes

Over recent decades, death rates from all causes, especially from cardiovascular disease, have declined among people with diabetes, likely due to better management and prevention strategies. However, as deaths from vascular causes decrease, a larger proportion of deaths are now due to non-vascular, non-cancer causes such as infections and kidney disease Rawshani2017Gregg2018Khalil2012. Despite these improvements, diabetes remains a significant contributor to premature mortality worldwide Rawshani2017Gregg2018Alegre-Díaz2016+3 MORE.

Conclusion

Diabetes significantly increases the risk of death from cardiovascular disease, kidney disease, infections, and respiratory illnesses, with cardiovascular causes being the most prominent. While overall mortality rates have declined, diabetes continues to be a major cause of premature death, highlighting the need for ongoing prevention, risk factor management, and improved access to care.

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Most relevant research papers on this topic

Diabetes Mellitus and Cause-Specific Mortality: A Population-Based Study

Diagnosis of diabetes is associated with increased mortality risk due to cardiovascular disease, chronic lower respiratory diseases, influenza and pneumonia, and kidney disease, but not cancer or Alzheimer's disease.

Observational StudyVery Rigorous JournalHighly Cited

2019·

238citations

·Sen Li et al.

Diabetes & Metabolism Journal·

DOI

Cause-specific mortality in a population-based study of diabetes.

Diabetic individuals experience very high mortality rates, particularly from vascular diseases, compared to the general population.

Observational StudyHighly Cited

1991·

341citations

·S. Moss et al.

American journal of public health·

DOI

Excess Mortality among Persons with Type 2 Diabetes.

Type 2 diabetes mortality rates vary greatly, with higher risks in younger patients, worse glycemic control, and greater renal complications, while lower risks are found in older patients and those with better glycemic control.

Rigorous JournalHighly Cited

2015·

501citations

·Mauro Tancredi et al.

The New England journal of medicine·

DOI

Cause-specific mortality in children and young adults with diabetes mellitus: A Danish nationwide cohort study.

Young persons with diabetes mellitus have a four-fold increased all-cause mortality and an eight-fold increased cardiovascular mortality compared to those without diabetes mellitus.

Observational Study

2019·

31citations

·J. Svane et al.

European journal of preventive cardiology·

DOI

Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes

In Sweden from 1998 to 2014, mortality and cardiovascular disease incidence declined substantially among individuals with diabetes, with fatal outcomes declining less among those with type 2 diabetes than controls.

Observational StudyRigorous JournalHighly Cited

2017·

1120citations

·A. Rawshani et al.

The New England Journal of Medicine·

DOI

Trends in cause-specific mortality among adults with and without diagnosed diabetes in the USA: an epidemiological analysis of linked national survey and vital statistics data.

Decreasing rates of vascular disease mortality are leading to a diversification of diabetes-related mortality, with implications for clinical management, prevention, and disease monitoring.

Observational StudyRigorous JournalHighly Cited

2018·

367citations

·E. Gregg et al.

Lancet·

DOI

Diabetes and Cause-Specific Mortality in Mexico City

In Mexico, diabetes is common, glycemic control is poor, and it accounts for at least one third of all deaths between ages 35 and 74, with a worse prognosis than in high-income countries.

Observational StudyRigorous JournalHighly Cited

2016·

244citations

·J. Alegre-Díaz et al.

The New England journal of medicine·

DOI

Diabetes Mellitus–Related All‐Cause and Cardiovascular Mortality in a National Cohort of Adults

Diabetes mellitus remains significantly associated with all-cause and cardiovascular mortality, but its impact on mortality is lower in the contemporary era than previously.

Observational StudyRigorous JournalHighly Cited

2019·

433citations

·S. Raghavan et al.

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease·

DOI

Cause-specific mortality in diabetes: recent changes in trend mortality

Better primary and secondary preventions in diabetes patients lead to decreased cardiovascular events and increased life expectancy, but increased survival in the general population leads to a higher incidence of type 2 diabetes worldwide.

Highly Cited

2012·

84citations

·C. A. Khalil et al.

European Journal of Preventive Cardiology·

DOI

Association of Diabetes With All-Cause and Cause-Specific Mortality in Asia

Diabetes in Asian populations is associated with increased risk of death from various diseases, particularly in women and younger patients.

Meta-AnalysisVery Rigorous JournalHighly Cited

2019·

153citations

·Jae-Jeong Yang et al.

JAMA Network Open·

DOI

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