Rate of deaths from vascular-related complications increasing for adults with diabetes
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Key takeaways:
- The rate of vascular-related deaths for adults with diabetes in the U.S. more than tripled from 2001 to 2020.
- The increased rate was mainly due to an increase in deaths from diabetic nephropathy.
SEATTLE — The rate of deaths attributed to vascular complications increased from 2001 to 2020 for adults with diabetes in the U.S., with the rise mainly due to an increase in deaths from diabetic nephropathy, according to a speaker.
“[There’s been an] increase in vascular complications by 6.8% [annually] in the last 2 decades,” Omolara Adeniran, MD, endocrinology fellow at the State University of New York (SUNY) Downstate University Hospital in Brooklyn, said during a presentation at the AACE Annual Scientific and Clinical Conference. “The largest increase experienced has been noted in 2009 to 2013.”
Adeniran and colleagues analyzed data collected from the National Center for Health Statistics on adults with diabetes in the U.S. who died from 2001 to 2020. Vascular complications of death included renal, ophthalmic, neurologic and peripheral circulatory complications. Age-adjusted mortality rates were calculated for each complication for every year. Joinpoint regression was performed using age-standardized mortality rates to investigate the overall trend of vascular complication-related deaths.
From 2001 to 2020, there were 4,957,211 diabetes-related deaths in the U.S., of which 16.1% were attributed to vascular-related complications. Of those who died, diabetes type was unspecified for 66.1%, 29.7% had type 2 diabetes and 4.2% had type 1 diabetes. Of those who died, 71.1% died of diabetic nephropathy, 27.1% died of peripheral circulatory complications, 1.5% died of diabetic neuropathy and 0.3% died of diabetic retinopathy.
The overall rate of vascular-related deaths increased from 572.3 per 10,000 people in 2001 to 1,759.1 per 10,000 in 2020. The increase mainly took place from 2009 to 2013, when overall vascular-related deaths increased by 36.6% per year. That increase was mainly due to a sharp increase in deaths from nephropathy. From 2009 to 2013, deaths attributed to nephropathy increased by 62.5% per year. From 2013 to 2020, however, there has been no significant change in the overall rate of deaths attributed to vascular-related complications or deaths attributed to nephropathy. The overall increase in deaths from vascular-related complications was 6.8% annually from 2001 to 2020.
“From 2009 to 2013 is where we had the upward trend,” Adeniran said. “But from 2013 to 2020, we see that it’s been relatively stable. In what direction is this [trend] going to take, we don’t know. We hope that it’s going to come down.”
Deaths attributed to diabetic retinopathy declined by 9.8% per year from 2001 to 2007 before increasing by 6.2% annually from 2007 to 2020. The rate of deaths from diabetic neuropathy was stable from 2001 to 2005 before increasing by 4.7% per year from 2005 to 2020. For deaths attributed to peripheral circulatory complications, the rate steadily declined by about 3.1% each year from 2001 to 2020.
“This is a wake-up call,” Adeniran said. “We should focus on and monitor patients who are diabetic and who have elevated microalbuminuria or high blood pressure ... as end-stage renal disease has been seen as one of the most common causes of death in this group of patients.”
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Adeniran O, et al. The trends of diabetes mortality attributed to vascular complications among U.S. adults (2001-2020). Presented at: American Association of Clinical Endocrinology Annual Scientific and Clinical Conference; May 4-6, 2023; Seattle.
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