Diabetes mortality rates declined in US from 2000 to 2019
Key takeaways:
- The diabetes mortality rate in the U.S. dropped from 28.1 deaths per 100,000 people in 2000 to 19.1 deaths per 100,000 in 2019.
- Reductions in diabetes mortality were observed for all racial and ethnic groups.
Diabetes mortality declined in the U.S. by 32.1% from 2000 to 2019, with decreases in mortality observed among all racial and ethnic groups and in most U.S. counties, researchers reported in Diabetes Care.
“Overall, these encouraging findings highlight the progress the field has made,” Ali H. Mokdad, PhD, chief strategy officer of population health and professor of health metrics sciences at University of Washington, told Healio. “Of course, substantial work remains to continue improving diabetes care in the U.S., particularly in areas where access to the latest, most effective therapies such as GLP-1s and SGLT2 inhibitors are low and where disparities in diabetes technology adoption are the greatest.”
Mokdad and colleagues obtained mortality data from the U.S. National Vital Statistics System from 2000 to 2019. ICD-10 codes were examined to extract deaths related to diabetes.
Diabetes mortality declines
Age-standardized diabetes mortality rates decreased from 28.1 deaths per 100,000 people in 2000 to 19.1 deaths per 100,000 people in 2019. Most of that decrease occurred from 2005 to 2013, when diabetes mortality dropped by 34.3%. Mortality rates increased by 1.9% from 2000 to 2005 and by 1.4% from 2013 to 2019.
Mokdad cited several factors that may have contributed to decreased diabetes mortality rates, including the availability of newer insulins, the approval of GLP-1s, more widespread use of statins for cardiovascular disease prevention, more aggressive management of hyperglycemia, hypertension and high cholesterol, and the American Diabetes Association opting to lower the threshold for diabetes from a fasting blood glucose level of 140 mg/dL to 126 mg/dL in 1996.
Decreasing mortality rates may be associated with improvements in diabetes management,” Mokdad said. “Improved management of both type 1 diabetes and type 2 diabetes is an important factor for the declines in mortality rates.”
Mortality down for all racial, ethnic groups
Diabetes mortality rates dropped among all racial and ethnic groups as follows:
- Native American and Alaska Native people, from 63.5 deaths per 100,000 people in 2000 to 35.6 deaths per 100,000 in 2019;
- Black people, from 56 deaths per 100,000 people in 2000 to 31.9 deaths per 100,000 people in 2019;
- Latino people, from 39.5 deaths per 100,000 people in 2000 to 19.7 deaths per 100,000 people in 2019;
- white people, from 24.6 deaths per 100,000 people in 2000 to 17.6 deaths per 100,000 people in 2019; and
- Asian people, from 18.1 deaths per 100,000 people in 2000 to 12.6 deaths per 100,000 people in 2019.
Diabetes mortality trends by region
A statistically significant decline in diabetes mortality was observed in 58.1% of U.S. counties. Statistically significant reductions in diabetes mortality were observed in 75.6% of counties for Black people, 75.5% of counties for Native American and Alaska Native people, 72.7% of counties for the Latino population, 49.5% of counties for white people and 31% of counties for Asian people.
The highest and lowest diabetes mortality rates in 2019 varied by racial and ethnic group around the country. The highest mortality rates for Native American and Alaska Native people were in central Mississippi, southwestern Oklahoma and eastern South Dakota, whereas diabetes mortality was highest for Black people in the Mississippi Delta region, northern Louisiana and southern Mississippi. Among the Latino population, 80% of the counties with the top 15 highest diabetes mortality rates were in western Texas. Diabetes mortality was highest for white people in the South and Appalachian Mountain regions of the U.S., whereas the highest diabetes mortality rates for the Asian population were broadly spread throughout counties in the West and Midwest.
The lowest diabetes mortality rates in 2019 were broadly dispersed for the Native American and Alaska Native, Black and Asian populations. Six of the top 15 counties with the lowest diabetes mortality for Latino people were in Mississippi, whereas 13 of the 31 counties with the lowest diabetes mortality for white people were in Colorado.
The difference in diabetes mortality rates between racial and ethnic groups declined from 2000 to 2019. However, Mokdad said more work is needed to further reduce racial and ethnic disparities in diabetes mortality.
“Addressing social determinants of health will be imperative to eliminating racial and ethnic disparities in mortality,” Mokdad said. “There is a need for resources that can facilitate healthier diets and for culturally sensitive and geographically accessible care.”
For more information:
Ali H. Mokdad, PhD, can be reached at mokdaa@uw.edu.
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