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These studies suggest that diabetes significantly increases mortality rates, with higher risks associated with renal disease, poor glycemic control, and sex-specific differences, while overall mortality rates have declined in some populations since 2000.
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Diabetes significantly impacts mortality rates globally, with variations observed based on type, demographic factors, and geographic regions. Studies have shown that individuals with diabetes have higher mortality rates compared to those without the condition, with specific trends and risk factors influencing these rates.
In randomized controlled trials (RCTs) involving subjects with type 2 diabetes, mortality rates vary widely. An analysis of 22 trials with over 91,842 patients revealed annualized mortality rates ranging from 0.28 to 8.24 per 100 patient-years. Higher mortality rates were associated with older age, longer diabetes duration, higher blood pressure, and chronic kidney disease.
A systematic review of observational studies from 1980 to 2019 indicated that all-cause mortality rates among people with diabetes have generally declined over the years. Specifically, 74% of the populations studied from 2000 to 2016 showed decreasing mortality trends. However, the decline was more pronounced in predominantly Europid populations compared to non-Europid populations.
Research indicates significant sex differences in mortality rates associated with type 1 diabetes. Women with type 1 diabetes have a 40% greater excess risk of all-cause mortality and twice the excess risk of fatal and nonfatal vascular events compared to men. Another study found that women with type 1 diabetes have a 58% greater risk of coronary heart disease mortality compared to men.
The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study showed that intensive therapy for type 1 diabetes resulted in mortality rates similar to the general U.S. population. However, conventional therapy was associated with higher mortality rates, particularly for individuals with higher HbA1c levels.
The International Diabetes Federation (IDF) estimated that in 2019, diabetes contributed to 11.3% of deaths globally among adults aged 20-79 years, equating to approximately 4.2 million deaths. The highest proportion of diabetes-attributable deaths was observed in the Middle East and North Africa, while the lowest was in the Africa Region.
In Mexico, a middle-income country with high obesity rates, diabetes was associated with a significantly worse prognosis compared to high-income countries. Diabetes accounted for at least one-third of all deaths among individuals aged 35-74 years, with the highest excess mortality risks observed for renal disease, cardiac disease, and infections.
Diabetes remains a significant contributor to global mortality, with notable differences based on type, sex, and geographic region. While mortality rates have generally declined over recent decades, particularly in high-income countries, the burden remains substantial, especially in middle-income regions. Effective diabetes management and targeted interventions are crucial to further reduce mortality rates and improve outcomes for individuals with diabetes.
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