Gregg EW, et al. - Researchers assessed the trends in diabetes-related morbidity among adults in the USA. The forms of diabetes-related mortality were seen to be diversified with declining rates of vascular disease mortality with implications for clinical management, prevention, and disease monitoring.

Methods

• Experts evaluated the 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, using data from the National Health Interview Survey Linked Mortality files from 1985 to 2015.

Results

• Findings suggested a decline in all-cause death rates from 1988-94, to 2010-15, 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]).
• As per data, a significant decrese in the death rates among people without diagnosed diabetes for all four major mortality categories was seen.
• Results demonstrated that nonetheless, the declines in death rates were significantly greater among people with diabetes for all-causes (p_interaction < 0·0001), vascular causes (p_interaction=0·0214), and non-vascular, non-cancer causes (p_interaction < 0·0001), as differences in all-cause and vascular disease death between people with and without diabetes were reduced by about a half.
• Researchers noted that among people with diabetes, all-cause mortality rates declined most in men and adults aged 65-74 years of age, and there was no decline in death rates among adults aged 20-44 years.
• In cause-specific mortality, the different magnitude of changes led to large changes in the proportional mortality.
• They noted that among adults with diabetes from vascular causes, the proportion of total deaths declined from 47·8% (95% CI 38·9-58·8) in 1988-94 to 34·1% (31·4-37·1) in 2010-15; this decline was offset by large increases in the proportion of deaths from non-vascular, non-cancer causes, from 33·5% (26·7-42·1) to 46·5% (43·3-50·0).
• Data demonstrated that over time, the proportion of deaths caused by cancer was relatively stable ranging from 16% to 20%.