This article is more than 5 years old. Information may no longer be current.
Deaths from diabetes more common than previously thought
Click Here to Manage Email Alerts
More deaths in the United States may be attributable to diabetes than previously thought, study data show.
“The frequency with which diabetes is listed as the underlying cause of death is not a reliable indicator of its actual contribution to the national mortality profile,” wrote Andrew Stokes, PhD, of the department of global health and Center for Global Health Development at Boston University School of Public Health, and Samuel H. Preston, PhD, of the department of sociology and the Population Studies Center at the University of Pennsylvania, Philadelphia. “The sensitivity and specificity of death certificate assignments of diabetes are low, far below those of administrative records or surveys. When both diabetes and cardiovascular disease are mentioned on a death certificate, whether or not diabetes is listed as the underlying cause is highly variable and to some extent arbitrary.”
The researchers used the National Health Interview Survey (NHIS) between 1997 and 2009 and National Health and Nutrition Examination Survey between 1999 and 2010 to estimate the population attributable fraction of deaths related to diabetes in cohorts aged 30 to 84 years (n = 282,322 for NHIS; n = 21,814 for NHANES). Stokes and Preston used self-reporting in both surveys to identify diabetes cases.
Previous estimates taken from the same surveys between 1976 and 1980 estimated that diagnosed diabetes was the cause of 3.6% of deaths, a number that rose to 5.1% when researchers included undiagnosed diabetes.
The researchers reported a significantly higher proportion of deaths attributable to the disease. Using the NHIS, researchers estimated 11.5% of deaths were attributable to diabetes; using the NHANES, the estimate was 11.7% using self-reported diabetes and 11.8% using HbA1c. Patients with obesity had the highest population attributable fraction for diabetes deaths, at 19.4%. The researchers wrote that previous estimates “severely understated the contribution of diabetes to mortality in the United States.”
“Responsibility for approximately 12% of deaths would make diabetes the third leading cause of death in the United States in 2010, after diseases of the heart and malignant neoplasms and ahead of chronic lower respiratory diseases and cerebrovascular diseases,” Stokes and Preston wrote. “These results demonstrate that diabetes is a major feature on the landscape of American mortality and reinforce the need for robust population-level interventions aimed at diabetes prevention and care.” – by Andy Polhamus
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts