Table 2.
Recent (2015 to 2021) publications with population-based data regarding trends in mortality in adults with diabetes
| Country | Study | Year | Data | Denominator | Numerator | Findings |
|---|---|---|---|---|---|---|
| Brazil | Malhão [8] | 1980–2012 | National vital statistics registry | Population | Age-standardised mortality |
Increased (per 100,000 individuals) from 20.8 to 47.6 in men and from 28.7 to 47.2 in women Largest increases were seen up to 2003–2005, then plateaued |
| Brazil | Klafke [62] | 1991–2010 | National vital statistics registry | Population | Age-standardised mortality (all-cause and due to acute complications) | Decreased from 8.4 to 2.5 per 100,000 individuals |
| Colombia | Chaparro-Narváez [63] | 1979–2017 | National vital statistics registry | Population | Age-standardised mortality |
1979–1999: increased (per 100,000 individuals) from 13.2 to 26.6 in women and from 10.1 to 22.7 in men 1999–2017: decreased (per 100,000 individuals) from 2.6 to 15.4 in women and from 22.7 to 15.9 in men |
| Argentina | Hernández [64] | 1990–2013 | National vital statistics registry | Population | Age-standardised mortality |
1990–2001: increased 2002–2013: decreased Greater declines in women Higher mortality over age 50 |
| Ghana | Sarfo-Kantanka [10] | 1983–2014 | Tertiary referral hospital (central Ghana) | People with DM (11,414) | In-hospital mortality | Increased from 7.6 to 30.0 per 1000 deaths |
| South Africa | Nojilana [9] | 1997–2010 | National vital statistics registry | Deaths in 2010 (594,071) | Cause-specific mortality |
Increased to 52 per 100,000 deaths Lower for White vs other groups |
| UK | Pearson-Stuttard [13] | 2011–2018 | National primary care database | People with DM (313,907) | Age-standardised mortality (all-cause and DM-specific) |
Decline in all-cause mortality in those with DM (31–32%); similar decline in non-DM Cause-specific declines except for dementia and liver disease |
| USA | Gregg [11] | 1988–1994 to 2010–2015 | National surveys linked to vital statistics | People with and without DM | Age-standardised mortality (all-cause and DM-specific) |
All-cause mortality (per 1000 person-years) declined from 23.1 to 15.2 More marked declines for vascular, then cancer deaths No decline in those aged < 45 years |
| China | Li [65] | 2003–2012 | National vital statistics registry | Population | Age-standardised mortality |
Decreasing More marked in urban populations |
| Hong Kong | Wu [12] | 2001–2016 | Electronic medical record diabetes registry | People with DM (390,071 men, 380,007 women) | Age-standardised mortality (all-cause and DM-specific) |
All-cause mortality declined (per 100,000 individuals) from 3.3 to 1.7 in women and from 2.8 to 1.5 in men No decline in those aged <45 years |
| Taiwan | Li [66] | 2005–2014 | National health insurance linked to vital statistics | People with DM | Age-standardised mortality (all-cause and DM-specific) |
All-cause mortality declined (per 100,000 individuals) from 3.1 to 2.7 in women and from 3.8 to 3.3 in men Shorter life expectancy with earlier-onset DM |
| Australia | Sacre [14] | 2002–2014 | National diabetes registry | People with T2DM (1,268,018) | Age-standardised mortality (all-cause and DM-specific) |
Declines of 1.3–2.2% points per year Declines more pronounced in middle and older ages All-cause, CVD and cancer deaths declined Pneumonia mortality remained stable |
| New Zealand | Yu [16] | 1994–2018 | National primary care database | People with T2DM (45,072) | Age-standardised mortality (all-cause and DM-specific) | Increased (per 1000 person-years) from 12.6 before 1998 to 19.4 in 1999–2003, and then decreased to 9.9 per 1000 person-years in 2014–2018 |
| Global | Ling [6] | 2000–2016 | WHO mortality database | People with T1DM, T2DM or other DM from 108 countries (7,108,145 deaths) | Mortality rates due to renal, ophthalmic, neurological and peripheral circulatory complications |
Increased from 46.0 to 60.2 per 100,000 individuals (30.8%) in both men and women Increased in T2DM and decreased in T1DM Higher for renal, neurological and peripheral circulatory complications Increased in all except Asia and South America (declined) |
| Global | Zaccardi [7] | 2000–2014 | WHO mortality database | People with DM | Total and hypoglycaemia-related mortality |
Increases (per 100,000 individuals) in total (from 912.5 to 1018.8) and hypoglycaemia-related deaths (from 654 to 1248) Lowest and declining rates in Europe, USA, Canada, Japan, NZ and Australia |
The literature included is composed of articles that reported data with international, national or at least subnational coverage and data sources such as registries or administrative/discharge records. This table does not include publications up to 2015 and is intended as an update to prior reviews [3]
DM, diabetes mellitus; NZ, New Zealand; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus