Trends in all-cause mortality among people with diagnosed diabetes in high-income settings: a multicountry analysis of aggregate data
Por:
Magliano, DJ, Chen, L, Carstensen, B, Gregg, EW, Pavkov, ME, Salim, A, Andes, LJ, Balicer, R, Baviera, M, Chan, JCN, Cheng, YLJ, Gardiner, H, Gulseth, HL, Gurevicius, R, Ha, KH, Jermendy, G, Kim, DJ, Kiss, Z, Leventer-Roberts, M, Lin, CY, Luk, AOY, Ma, S, Mata-Cases, M, Mauricio, D, Nichols, GA, Pildava, S, Porath, A, Read, SH, Robitaille, C, Roncaglioni, MC, Ruiz, PLD, Wang, KL, Wild, SH, Yekutiel, N, Shaw, JE
Publicada:
1 feb 2022
Ahead of Print:
1 ene 2022
Resumen:
Background Population-level trends in mortality among people with diabetes are inadequately described. We aimed to examine the magnitude and trends in excess all-cause mortality in people with diabetes.
Methods In this retrospective, multicountry analysis, we collected aggregate data from 19 data sources in 16 highincome countries or jurisdictions (in six data sources in Asia, eight in Europe, one from Australia, and four from North America) for the period from Jan 1, 1995, to Dec 31, 2016, (or a subset of this period) on all-cause mortality in people with diagnosed total or type 2 diabetes. We collected data from administrative sources, health insurance records, registries, and a health survey. We estimated excess mortality using the standardised mortality ratio (SMR).
Findings In our dataset, there were approximately 21 million deaths during 0.5 billion person-years of follow-up among people with diagnosed diabetes. 17 of 19 data sources showed decreases in the age-standardised and sexstandardised mortality in people with diabetes, among which the annual percentage change in mortality ranged from -0.5% (95% CI -0.7 to -0.3) in Hungary to -4.2% (-4.3 to -4.1) in Hong Kong. The largest decreases in mortality were observed in east and southeast Asia, with a change of -4.2% (95% CI -4.3 to -4.1) in Hong Kong, -4.0% (-4.8 to -3.2) in South Korea, -3.5% (-4.0 to -3.0) in Taiwan, and -3.6% (-4.2 to -2.9) in Singapore. The annual estimated change in SMR between people with and without diabetes ranged from -3.0% (95% CI -3.0 to -2.9; US Medicare) to 1.6% (1.4 to 1.7; Lombardy, Italy). Among the 17 data sources with decreasing mortality among people with diabetes, we found a significant SMR increase in five data sources, no significant SMR change in four data sources, and a significant SMR decrease in eight data sources.
Interpretation All-cause mortality in diabetes has decreased in most of the high-income countries we assessed. In eight of 19 data sources analysed, mortality decreased more rapidly in people with diabetes than in those without diabetes. Further longevity gains will require continued improvement in prevention and management of diabetes. Copyright (C) 2021 Elsevier Ltd. All rights reserved.
Filiaciones:
Magliano, DJ:
Baker Heart & Diabet Inst, Dept Diabet & Populat Hlth, Melbourne, Vic, Australia
Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia
Chen, L:
Baker Heart & Diabet Inst, Dept Diabet & Populat Hlth, Melbourne, Vic, Australia
Carstensen, B:
Steno Diabet Ctr Copenhagen, Clin Epidemiol, Gentofte, Denmark
Gregg, EW:
Imperial Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England
Pavkov, ME:
Ctr Dis Control & Prevent, Div Diabet Translat, Atlanta, GA USA
Salim, A:
Baker Heart & Diabet Inst, Dept Diabet & Populat Hlth, Melbourne, Vic, Australia
Univ Melbourne, Melbourne Sch Populat & Global Hlth, Melbourne, Vic, Australia
Andes, LJ:
Ctr Dis Control & Prevent, Div Diabet Translat, Atlanta, GA USA
Balicer, R:
Clalit Hlth Serv, Clalit Res Inst, Tel Aviv, Israel
Baviera, M:
Mario Negri Inst Pharmacol Res IRCCS, Lab Cardiovasc Prevent, Milan, Italy
Chan, JCN:
Chinese Univ Hong Kong, Prince Wales Hosp, Li Ka Shing Inst Hlth Sci, Hong Kong Inst Diabet & Obes,Dept Med & Therapeut, Hong Kong, Peoples R China
Cheng, YLJ:
Ctr Dis Control & Prevent, Div Diabet Translat, Atlanta, GA USA
Gardiner, H:
Publ Hlth Agcy Canada, Ctr Surveillance & Appl Res, Ottawa, ON, Canada
Gulseth, HL:
Norwegian Inst Publ Hlth, Dept Chron Dis & Ageing, Oslo, Norway
Gurevicius, R:
Inst Hyg, Ctr Hlth Informat, Vilnius, Lithuania
Mykolas Romeris Univ, Fac Publ Governance & Business, Vilnius, Lithuania
Ha, KH:
Ajou Univ, Dept Endocrinol & Metab, Sch Med, Suwon, South Korea
Jermendy, G:
Bajcsy Zsilinszky Hosp, Med Dept 3, Budapest, Hungary
Kim, DJ:
Ajou Univ, Dept Endocrinol & Metab, Sch Med, Suwon, South Korea
Kiss, Z:
Univ Pecs, Med Fac, Dept Med 2, Pecs, Hungary
Univ Pecs, Med Fac, Nephrol Ctr, Pecs, Hungary
Leventer-Roberts, M:
Clalit Hlth Serv, Clalit Res Inst, Tel Aviv, Israel
Icahn Sch Med Mt Sinai, Dept Pediat, New York, NY 10029 USA
Icahn Sch Med Mt Sinai, Dept Environm Med & Publ Hlth, New York, NY 10029 USA
Lin, CY:
Taipei Vet Gen Hosp, Gen Clin Res Ctr, Taipei, Taiwan
Luk, AOY:
Chinese Univ Hong Kong, Prince Wales Hosp, Li Ka Shing Inst Hlth Sci, Hong Kong Inst Diabet & Obes,Dept Med & Therapeut, Hong Kong, Peoples R China
Ma, S:
Minist Hlth, Epidemiol & Dis Control Div, Publ Hlth Grp, Singapore, Singapore
Mata-Cases, M:
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis, Barcelona, Spain
Inst Univ Invest Atencio Primaria Jordi Gol IDIAP, Inst Catala Salut, Unitat Suport Recerca Barcelona Ciutat, Barcelona, Spain
Mauricio, D:
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis, Barcelona, Spain
Inst Univ Invest Atencio Primaria Jordi Gol IDIAP, Inst Catala Salut, Unitat Suport Recerca Barcelona Ciutat, Barcelona, Spain
Autonomous Univ Barcelona, Dept Endocrinol & Nutr, Hosp Santa Creu & St Pau, Barcelona, Spain
Nichols, GA:
Kaiser Permanente Ctr Hlth Res, Sci Programs Dept, Portland, OR USA
Pildava, S:
Ctr Dis Prevent & Control, Res & Hlth Stat Dept, Riga, Latvia
Porath, A:
Maccabi Healthcare Serv, Res Inst, Tel Aviv, Israel
Ben Gurion Univ Negev, Fac Hlth, Beer Sheva, Israel
Read, SH:
Univ Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland
Robitaille, C:
Publ Hlth Agcy Canada, Ctr Surveillance & Appl Res, Ottawa, ON, Canada
Roncaglioni, MC:
Mario Negri Inst Pharmacol Res IRCCS, Lab Cardiovasc Prevent, Milan, Italy
Ruiz, PLD:
Norwegian Inst Publ Hlth, Dept Chron Dis & Ageing, Oslo, Norway
Oslo Univ Hosp, Dept Endocrinol Morbid Obes & Prevent Med, Oslo, Norway
Wang, KL:
Taipei Vet Gen Hosp, Gen Clin Res Ctr, Taipei, Taiwan
Wild, SH:
Univ Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland
Yekutiel, N:
Maccabi Healthcare Serv, Res Inst, Tel Aviv, Israel
Shaw, JE:
Baker Heart & Diabet Inst, Dept Diabet & Populat Hlth, Melbourne, Vic, Australia
Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia
La Trobe Univ, Sch Life Sci, Melbourne, Vic, Australia
Green Submitted
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