The decline in mortality due to acute complications of diabetes mellitus in Brazil, 1991–2010

Abstract

BackgroundMortality from acute complications of diabetes, a predominantly preventable condition, although controlled in high income countries, remains a major challenge for low/middle income countries. The aim of this study is to describe trends in mortality from acute complications of diabetes between 1991 and 2010 in Brazil, a period during which a national health system was implemented offering broad access to diabetes treatment.MethodsWe obtained the number of deaths listed in the Brazilian Mortality Information System between 1991 and 2010 as due to acute complications of diabetes (ICD-9 250.1, .2, or .3 and ICD-10 E10–14.0 or 1), corrected this number for ill-defined causes of death and incompleteness in mortality reporting, and calculated mortality rates standardized to the world’s population. We describe mortality trends with Joinpoint regressions.ResultsOver this 20 year period, mortality due to the acute complications of diabetes fell 70.9 % (95 % CI 67.2 to 74.5 %), from 8.42 (95 % CI 8.27 to 8.57) deaths per 100000 inhabitants in 1991 to 2.45 (95 % CI 2.38 to 2.52) per 100000 in 2010. The reduction occurred in men and women, in all age groups, and in all regions of Brazil.ConclusionsMortality from acute complications of diabetes in Brazil has declined markedly in parallel with the implementation of a national health system providing access to insulin and organization of health care. Further decline is possible and necessary.

Time trends in adult chronic disease inequalities by education in Brazil: 1998–2013

“…Nonetheless, some progress has been made in recent years as evidenced by the decline in age-standardized mortality rates due to chronic non-communicable diseases between 1996 and 2007 [1]. For example, mortality rates due to acute complications of diabetes declined between 1991 and 2010 [7]. Between 1996 and 2007, age-adjusted mortality attributable to non-communicable diseases declined by about 20 %, primarily associated with reductions in cardiovascular disease [1, 8].…”

Effectiveness and Safety of Intravitreal Dexamethasone Implant (Ozurdex) in Patients with Diabetic Macular Edema: A Real-World Experience

“…With an estimated prevalence among adults of at least 6.3%, Brazil is the country with the fourth largest number of diabetic individuals in the world [2]. Despite advances in metabolic control and a recent reduction in mortality due to acute complications of diabetes in Brazil [3], these patients continue to be at risk for a series of clinical problems. Among the various ocular complications of diabetes, diabetic retinopathy is the most important in terms of public health and is a major cause of vision loss and blindness in adults aged 40 years or older [4].…”

Tendência de mortalidade por diabetes mellitus

“…It is shown that this data is consistent with those obtained at the national level and in the Northeast region. 8,23 It is inferred that, although the trend of decreasing mortality trend was verified, overall, in Ceará, the year of 2011 was affected by the significant increase in the number of deaths. It should be noted that data from the Brazilian Ministry of Health and the Health Secretariat of the State of Ceará drew attention to this, however, it was not evident what led to the abrupt increase in the mortality rate in the year in question and not even the which led to a decrease in subsequent periods.…”

“…It is reported that this data is particularly important, since, previously, the data pointed to a greater trend of DM mortality in the states and capitals of the Northeastern region. [7][8] When the data were stratified by sex, a trend curve for the trend of mortality for women in the State of Ceará was denoted. It is shown that this data is consistent with those obtained at the national level and in the Northeast region.…”

“…6 In recent decades, the high mortality rates and the burden generated by the disease in the capitals and states of the Northeast region of Brazil have been verified. [7][8] The need to evaluate the parameters of illness and death of a population is highlighted because this analysis can subsidize the proposal of public policies and the assessment of the management and planning of promotion and prevention actions carried out by the health services. It is understood that, this approach can be given by the historical series study of mortality trend.…”