Objective: This multi-country study explored trends in causes of death in people with diabetes.
Methods: We used cause-specific mortality data in people with diabetes from 9 high-income countries (2000-2020). Data were from registries, health insurance, or other administrative sources. Proportional contributions of causes of death to total deaths across 10 groups (cancer, cardiovascular [CVD], dementia, diabetes, influenza and pneumonia, infection, liver, renal, respiratory disease, and all others) were age-standardized and regressed against time.
Results: We included 1,624,100 deaths from 9 jurisdictions. In all jurisdictions, there was a shift in the most common causes of death away from CVD and diabetes. The decline in the proportion of deaths due to CVD ranged from 0.34% to 2.32% per year (all Ptrend < 0.001). Deaths due to diabetes declined in 8/9 jurisdictions with magnitudes from 0.09% to 0.87% per year but rose in Lithuania (0.64% per year). Dementia deaths rose in 8/9 jurisdictions (0.07% to 0.52% per year) as did the proportion of deaths due to ‘other’ causes. Cancer deaths rose in 5/9 jurisdictions. Trends in the remaining cause-of-death categories showed varied patterns.
Conclusion: There has been a shift in causes of death among those with diabetes away from CVD and diabetes. The increasing proportion of deaths due to dementia and cancer may require consideration when planning resource allocation.
D.J. Magliano: None. J.I. Morton: None. L. Chen: None. J.W. Sacre: None. B. Carstensen: Stock/Shareholder; Novo Nordisk. E.W. Gregg: None. M.E. Pavkov: None. M. Arffman: Research Support; Roche Pharmaceuticals. M. Chu: None. K. Eeg-Olofsson: Other Relationship; Abbott, Eli Lilly and Company, Novo Nordisk, Sanofi. K. Fleetwood: None. S. Fosse-Edorh: None. M. Guion: None. R. Gurevicius: None. K. Ha: None. P. Kaul: None. D. Kim: None. T. Laurberg: None. S. Wild: Other Relationship; Novo Nordisk, Novo Nordisk Foundation. J.E. Shaw: Advisory Panel; GlaxoSmithKline plc. Research Support; AstraZeneca. Advisory Panel; AstraZeneca. Speaker's Bureau; AstraZeneca, Roche Diabetes Care, Boehringer-Ingelheim, Zuellig Pharma Holdings Pte. Ltd. Advisory Panel; Novo Nordisk. Speaker's Bureau; Roche Diagnostics. Advisory Panel; Roche Diagnostics, Eli Lilly and Company. Speaker's Bureau; Eli Lilly and Company. Advisory Panel; Abbott, Mylan. Speaker's Bureau; Sanofi.
Centers for Disease Control and Prevention, United States
