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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

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

BMC Public Health > Ausgabe 1/2015
André Klafke, Bruce Bartholow Duncan, Antony Stevens, Roger dos Santos Rosa, Lenildo de Moura, Deborah Malta, Maria Inês Schmidt
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

AK, BBD and MIS participated in the conception and design of the study; AK, BBD and AS, in data analysis; AK, BBD and MIS, in data interpretation; and all authors in drafting relevant or critical revision of the intellectual content of the manuscript and final approval of the version to be published. All authors read and approved the final manuscript.



Mortality 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.


We 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.


Over 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.


Mortality 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.
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