Diabetes deadlier than previous estimates

Diabetes contributes to more deaths than we think.

A new analysis published in the journal PLOS ONE found the proportion of deaths attributable to diabetes was nearly 12 percent. That would make diabetes the third leading cause of death in the United States in 2010 behind heart disease and cancer.

In actuality, only 3-4 percent of death certificates identified diabetes as the underlying cause, ranking it the seventh leading cause of death in 2010.

“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,” conclude co-authors Andrew Stokes, assistant professor of global health at Boston University School of Public Health researcher, and Samuel Preston, professor of sociology and a researcher with the Population Studies Center at the University of Pennsylvania. “The sensitivity and specificity of death certificate assignments of diabetes as an underlying cause of death are low, far below those of administrative records or surveys. People who die with diabetes typically have other conditions that may contribute to death.”

However, 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.”

To calculate the estimates, researchers calculated the prevalence of diabetes in the population as well as excess mortality risk among people with diabetes over five years of follow up. They used two large data sets that included more than 300,000 among individuals ages 30 to 84 between 1997 and 2011. 

Topics: Clinical