The online version of this article (doi:10.1186/s12902-015-0042-1) contains supplementary material, which is available to authorized users.
Meiying Zhu and Jiang Li contributed equally to this work.
The authors declare that they have no competing interests.
MZ constructed the study, and took charge of the data collection, management and interpretation. JL designed the study, and did the data analysis, and interpretation, literature searches, and wrote the first draft of the report. DD constructed the study, and contribute to study design. ZL, WL gathered, interpreted, and analysed the data, SRW, CS and RL contributed to study design, writing of the draft and review and critique of the manuscript. All authors have fulfilled authorship criteria per ICMJE guidelines and have approved the manuscript and this submission. JL is guarantor for the study, had full access to the data in the study, and take responsibility for the integrity of the data and the accuracy of the data analysis.
China is one of the countries with the highest prevalence of diabetes in the world. We analysed all the death certificates mentioning diabetes from 2002 to 2012 in Songjiang District of Shanghai to estimate morality rates and examine cause of death patterns.
Mortality data of 2654 diabetics were collected from the database of local CDC. The data set comprises all causes of death, contributing causes and the underlying cause, thereby the mortality rates of diabetes and its specified complications were analysed.
The leading underlying causes of death were various cardiovascular diseases (CVD), which collectively accounted for about 30 % of the collected death certificates. Diabetes was determined as the underlying cause of death on 28.7 %. The trends in mortality showed that the diabetes related death rate increased about 1.78 fold in the total population during the 11-year period, and the death rate of diabetes and CVD comorbidity increased 2.66 fold. In all the diabetes related deaths, the proportion of people dying of ischaemic heart disease or cerebrovascular disease increased from 18.0 % in 2002 to 30.5 % in 2012. But the proportions attributed directly to diabetes showed a downtrend, from 46.7–22.0 %.
The increasing diabetes related mortality could be chiefly due to the expanding prevalence of CVD, but has nothing to do with diabetes as the underlying cause. Policy makers should pay more attention to primary prevention of diabetes and on the prevention of cardiovascular complications to reduce the burden of diabetes on survival.
Additional file 1: Dataset. This Excel dataset was used for all the analysis of the present study. (XLS 602 kb)12902_2015_42_MOESM1_ESM.xls
Additional file 2: Figure S1. The Proportion of diabetes types in the diabetes related deaths from 2002 to 2012. The blocks indicate the proportions of type 2 diabetes, unspecified type, and other specified types (including type 1 diabetes) in each year, respectively. (PDF 154 kb)12902_2015_42_MOESM2_ESM.pdf
Additional file 3: Table S1. Annual number of deaths according to different sub-groups from 2002 to 2012. (PDF 43 kb)12902_2015_42_MOESM3_ESM.pdf
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- Mortality rates and the causes of death related to diabetes mellitus in Shanghai Songjiang District: an 11-year retrospective analysis of death certificates
Scott R. Weaver
- BioMed Central
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