Trends in cause-specific mortality among adults with and without diagnosed diabetes in the USA: an epidemiological analysis of linked national survey and vital statistics data

Large reductions in diabetes complications have altered diabetes-related morbidity in the USA. It is unclear whether similar trends have occurred in causes of death. Using data from the National Health Interview Survey Linked Mortality files from 1985 to 2015, we estimated age-specific death rates a...

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Bibliographic Details
Published in:The Lancet (British edition) 2018-06, Vol.391 (10138), p.2430-2440
Main Authors: Gregg, Edward W, Cheng, Yiling J, Srinivasan, Meera, Lin, Ji, Geiss, Linda S, Albright, Ann L, Imperatore, Giuseppina
Format: Article
Language:English
Subjects:
Adult
Adults
Age
Age Factors
Aged
Alzheimer's disease
Cancer
Death
Diabetes
Diabetes mellitus
Diabetes Mellitus - diagnosis
Diabetes Mellitus - epidemiology
Diabetes Mellitus - mortality
Disease control
Epidemiology
Fatalities
Female
Health risk assessment
Health Surveys
Humans
Hypertension
Influenza
Kidney diseases
Life expectancy
Liver diseases
Male
Medical diagnosis
Middle Aged
Morbidity
Mortality
Mortality - trends
Neoplasms - mortality
Parkinson's disease
Pneumonia
Population
Sepsis
Sex Factors
Statistical analysis
Trends
United States - epidemiology
Vascular diseases
Vascular Diseases - mortality
Vital Statistics
Young Adult
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Summary:Large reductions in diabetes complications have altered diabetes-related morbidity in the USA. It is unclear whether similar trends have occurred in causes of death. Using data from the National Health Interview Survey Linked Mortality files from 1985 to 2015, we estimated age-specific death rates and proportional mortality from all causes, vascular causes, cancers, and non-vascular, non-cancer causes among US adults by diabetes status. From 1988–94, to 2010–15, all-cause death rates declined by 20% every 10 years among US adults with diabetes (from 23·1 [95% CI 20·1–26·0] to 15·2 [14·6–15·8] per 1000 person-years), while death from vascular causes decreased 32% every 10 years (from 11·0 [9·2–12·2] to 5·2 [4·8–5·6] per 1000 person-years), deaths from cancers decreased 16% every 10 years (from 4·4 [3·2–5·5] to 3·0 [2·8–3·3] per 1000 person-years), and the rate of non-vascular, non-cancer deaths declined by 8% every 10 years (from 7·7 [6·3–9·2] to 7·1 [6·6–7·5]). Death rates also declined significantly among people without diagnosed diabetes for all four major mortality categories. However, the declines in death rates were significantly greater among people with diabetes for all-causes (pinteraction
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(18)30314-3