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Ann Intern Med. 2007 Aug 7;147(3):149-55. Epub 2007 Jun 18.

Mortality trends in men and women with diabetes, 1971 to 2000.

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  • 1National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3727, USA.

Abstract

BACKGROUND:

Whether mortality rates among diabetic adults or excess mortality associated with diabetes in the United States has declined in recent decades is not known.

OBJECTIVE:

To examine whether all-cause and cardiovascular disease mortality rates have declined among the U.S. population with and without self-reported diabetes.

DESIGN:

Comparison of 3 consecutive, nationally representative cohorts.

SETTING:

Population-based health surveys (National Health and Nutrition Examination Surveys I, II, and III) with mortality follow-up assessment.

PATIENTS:

Survey participants age 35 to 74 years with and without diabetes.

MEASUREMENTS:

Diabetes was determined by self-report for each survey (1971-1975, 1976-1980, and 1988-1994), and mortality rates were determined through 1986, 1992, and 2000 for the 3 surveys, respectively.

RESULTS:

Among diabetic men, the all-cause mortality rate decreased by 18.2 annual deaths per 1000 persons (from 42.6 to 24.4 annual deaths per 1000 persons; P = 0.03) between 1971 to 1986 and 1988 to 2000, accompanying decreases in the nondiabetic population. Trends for cardiovascular disease mortality paralleled those of all-cause mortality, with 26.4 annual deaths per 1000 persons in 1971 to 1986 and 12.8 annual deaths per 1000 persons in 1988 to 2000 (P = 0.06). Among women with diabetes, however, neither all-cause nor cardiovascular disease mortality declined between 1971 to 1986 and 1988 to 2000, and the all-cause mortality rate difference between diabetic and nondiabetic women more than doubled (from a difference of 8.3 to 18.2 annual deaths per 1000 persons). The difference in all-cause mortality rates by sex among people with diabetes in 1971 to 1986 were essentially eliminated in 1988 to 2000.

LIMITATIONS:

Diabetes was assessed by self-report, and statistical power to examine the factors explaining mortality trends was limited.

CONCLUSIONS:

Progress in reducing mortality rates among persons with diabetes has been limited to men. Diabetes continues to greatly increase the risk for death, particularly among women.

PMID:
17576993
[PubMed - indexed for MEDLINE]
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