Global trend of diabetes mortality attributed to vascular complications, 2000–2016

Abstract

Background The global epidemic of diabetes mellitus continues to grow and affects developed and developing countries alike. Intensive glycemic control is thought to modify the risks for vascular complications, hence the risks for diabetes-related death. We investigated the trend of diabetic vascular complication-related deaths between 2000 and 2016 in the global diabetes landscape. Methods We collected 17 years of death certificates data from 108 countries in the World Health Organization mortality database between 2000 and 2016, with coding for diabetic complications. Crude and age-standardized proportions and rates were calculated. Trend analysis was done with annual average percentage change (AAPC) of rates computed by joinpoint regression. Results From 2000 through 2016, 7,108,145 deaths of diabetes were reported in the 108 countries. Among them, 26.8% (1,904,787 cases) were attributed to vascular complications in damaged organs, including the kidneys (1,355,085 cases, 71.1%), peripheral circulatory (515,293 cases, 27.1%), nerves (28,697 cases, 1.5%) and eyes (5751 cases, 0.3%). Overall, the age-standardized proportion of vascular complication-related mortality was 267.8 [95% confidence interval (95% CI), 267.5–268.1] cases per 1000 deaths and the rate was 53.6 (95% CI 53.5–53.7) cases per 100,000 person-years. Throughout the 17-year period, the overall age-standardized proportions of deaths attributable to vascular complications had increased 37.9%, while the overall age-standardized mortality rates related to vascular complications had increased 30.8% (AAPC = 1.9% [1.4–2.4%, p < 0.05]). These increases were predominantly driven by a 159.8% increase in the rate (AAPC = 2.7% [1.2–4.3%, p < 0.05]) from renal complications. Trends in the rates and AAPC of deaths varied by type of diabetes and of complications, as well as by countries, regions and domestic income. Conclusion Diabetic vascular complication-related deaths had increased substantially during 2000–2016, mainly driven by the increased mortality of renal complications.

Up and down waves of glycemic control and lower-extremity amputation in diabetes

“…PAD is strictly related to the onset and the prognosis of diabetic foot ulcers, determining an increase of the risk of LEA [ 18 ]. In the World Health Organization mortality database collecting data in 108 countries from 2000 to 2016, a proportion of 27.1% deaths (515.293 cases) was referred to macrovascular complications affecting the peripheral arteries [ 19 ]. The US national decline in glycemic control after 2010 has been associated with a resurgence of LEA in the young and middle-aged US diabetic population.…”

Comparing of the Effects of Acceptance and Commitment Therapy and Emotion Regulation Training on Diabetes Empowerment

“…The prevalence of diabetes and pre-diabetes in Iranians aged >35 years is estimated to be approximately 18% and 34%, respectively (Shamshirgaran et al 2020). The annual worldwide diabetes-related mortality rate is about 53.6 per 100000 cases (Ling et al 2020). A significant percentage of patients with diabetes experience low Quality of Life (QoL) (Waari, Mutai & Gikunju 2018); most of them are not satisfied with medications and continuous regimen which put them under consistent stress.…”

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“…Patients with diabetes have a three-fold increased risk of developing cardiovascular disease [ 1 , 2 ]; this risk is driven by microvascular (retinopathy, neuropathy, nephropathy) and macrovascular (peripheral vascular disease, stroke, and coronary artery disease) complications. In fact, over the last two decades global mortality rate attributable to vascular complications in diabetes has increased by 37.9% [ 3 ].…”

“…Adjusted for potential confounders 2. Composite endpoint of all-cause mortality, doubling of serum creatinine, or requirement for dialysis 3. Composite endpoint of acute ischemic events (acute coronary syndrome, stroke, or transient ischemic attack), heart failure, or death.…”