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Progress in Chronic Disease Prevention Chronic Disease Reports: Deaths from Diabetes -- United States, 1986

In 1986, diabetes (International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) 250) was listed as the underlying cause of death for 37,178 persons in the United States. Diabetes mortality rates (age-standardized to the 1986 U.S. population) were lowest in Nevada (11.6 per 100,000) and highest in Delaware (26.3 per 100,000) (Figure 1, Table 1).

Diabetes-related deaths accounted for 1.8% of U.S. mortality and for 1% of years of potential life lost before age 65 (1). However, diabetes was mentioned as a con tributory cause of death on 4.1 times as many death certificates as it was selected as the underlying cause (Table 2). Moreover, diabetes was not listed on approximately half of death certificates for persons with noninsulin-dependent diabetes (2). Thus, diabetes may be associated with approximately eight times as many deaths as indicated by underlying cause alone.

Rates of diabetes mortality declined in the 1970s, but the decline has slowed in recent years (3). Rates of diabetes mortality increase with age, are 6% higher in males than in females and 39% higher in nonwhites than in whites (4). Smoking, hypertension, and overweight are modifiable risk factors for death among diabetic persons (Table 2); estimates of deaths that could be averted by eliminating these risk factors are substantial (Table 2). Diabetes also contributes to end-stage renal disease, amputations, blindness, and other serious complications; associated risk factors include higher levels of glycemia, smoking, and hypertension. Assuming that risk-factor reduction among diabetic persons would have the same benefit as in the general population, more effective control of smoking, hypertension, and overweight should further decrease morbidity and mortality rates among diabetic persons. Reported by: Div of Surveillance and Epidemiologic Studies, Epidemiology Program Office; Div of Diabetes Translation, Center for Chronic Disease Prevention and Health Promotion, CDC.

References

  1. CDC. Years of potential life lost before age 65--United States, 1987. MMWR 1989;38:27-9.

  2. Herman WH, Teutsch SM, Geiss LS. Closing the gap: the problem of diabetes mellitus in the United States. Diabetes Care 1985;8:391-406.

  3. CDC. Trends in diabetes mellitus mortality. MMWR 1988;37:769-73.

  4. NCHS. Vital statistics of the United States, 1986. Vol. II--Mortality, pt A. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, 1988; DHHS publication no. (PHS)88-1122.



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