Korean Diabetes J.  2009 Feb;33(1):65-72. 10.4093/kdj.2009.33.1.65.

Cause-of-Death Trends for Diabetes Mellitus over 10 Years

• Park SK
• Park MK
• Suk JH
• Kim MK
• Kim YK
• Kim IJ
• Kang YH
• Lee KJ
• Lee HS
• Lee CW
• Kim BH
• Lee KI
• Kim MK
• Kim DK

• KMID: 2222485
• DOI: http://doi.org/10.4093/kdj.2009.33.1.65

Abstract

BACKGROUND: Recently, diabetic mortality is lower than ever before, likely due to dramatic improvements in diabetes care. This study set to analyze changes in the cause of death in type 2 diabetes mellitus (T2DM) in the past 10 years.
METHODS
All subjects were T2DM patients over the age of 30 whose death certificates were issued at six hospitals in the Busan metropolitan area from 2000 to 2004. The patients were excluded if they had been clinically diagnosed with significant tuberculosis, liver, thyroid, renal, connective tissue diseases and cancers, prior to T2DM diagnosis. We classified the cause of death into several groups by KCD-4. The results were compared with published data on the period from 1990 to 1994.
RESULTS
The study comprised 680 patients, of which 374 (55.0%) were male. The average age of death was 66.3 +/- 10.7 years. The most common cause of death was cardiovascular disease (30.6%), followed by infectious disease (25.3%), cancer (21.9%), congestive heart failure (7.1%), renal disease (4.7%), liver disease (2.7%), and T2DM itself (1.9%). In the study from the earlier period, the most common cause of death was also cardiovascular disease (37.6%), followed by infectious disease (24.2%), T2DM (6.0%), liver disease (5.4%), cancer (4.7%), and renal disease (3.3%).
CONCLUSION
Over both study periods, the first and second cause of death in T2DM were cardiovascular disease and infectious disease, respectively. However, death by cerebral infarction among cardiovascular disease patients was significantly lower in the latter period, while death by malignancy was markedly increased.

Keyword

Cause of death; Diabetes mellitus; Mortality

MeSH Terms

Cardiovascular Diseases
Cause of Death
Cerebral Infarction
Communicable Diseases
Connective Tissue Diseases
Death Certificates
Diabetes Mellitus
Diabetes Mellitus, Type 2
Heart Failure
Humans
Liver
Liver Diseases
Male
Thyroid Gland
Tuberculosis

Figure

• 

  Fig. 1 The comparison of the proportion of the causes of death in the subjects between 1990~1994 and 2000~2004. *P < 0.001. CHF, congestive heart failure; CVD, cardiovascular disease; DM, diabetes mellitus; Etc, others; ID, infectious disease; LD, liver disease; Mal., malignancy; RD, renal disease.

• 

  Fig. 2 Infectious causes of death in the subjects. The cause of death in sepsis (n = 106) can be divided as 'with DM foot' (n = 25) and 'without DM foot' (n = 81). DM, diabetes mellitus; Tbc, pulmonary tuberculosis.

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