Reductions in excess mortality rates among people with diabetes by selected cause of death

Tierney, Edward F.; Cadwell, Betsy L.; Thompson, Theodore J.; Boyle, James P.; Paxon, Sherri L.; Moum, Kathy; Engelgau, Michael M.

doi:10.1016/j.jdiacomp.2007.12.002

« Previous Next »Journal of Diabetes and Its Complications
Volume 23, Issue 2 , Pages 77-82, March 2009

Reductions in excess mortality rates among people with diabetes by selected cause of death☆

Edward F. Tierney
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Corresponding author. Division of Diabetes Translation, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS K-10, Atlanta, GA 30341, USA. Tel.: +1 770 488 1058; fax: +1 770 488 1148.
Betsy L. Cadwell
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
Theodore J. Thompson
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
James P. Boyle
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
Sherri L. Paxon
- Division of Chronic Disease, North Dakota Department of Health, Bismarck, ND, USA
Kathy Moum
- Division of Chronic Disease, North Dakota Department of Health, Bismarck, ND, USA
Michael M. Engelgau
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA

Received 9 July 2007; received in revised form 24 September 2007; accepted 7 December 2007. published online 14 March 2008.

Abstract

We applied Bayesian methods to estimate excess mortality rates by selected causes of death for decedents with diabetes compared to those without diabetes in North Dakota and assessed changes in the excess rate between 1992–1998 and 1999–2003. We report the probability (Pr) of a rate decrease in the age-adjusted excess rate and considered the evidence strong if the probability was 0.90 or higher. Among men with diabetes, the evidence was strong for a probable decrease in excess rate for heart disease (8.7 per 1000 to 6.5), cerebrovascular disease (1.2 per 1000 to 0.75) and arterial disease (0.24 per 1000 to 0.08). Among women with diabetes, the evidence was strong for a probable decrease in excess rates for the overall (total) rate (17.8 per 1000 to 12.6), for heart disease (6.1 per 1000 to 4.4), IHD (4.4 per 1000 to 3.1), cerebrovascular disease (1.4 per 1000 to 0.5), arterial disease (0.17 per 1000 to 0.10) and cancer (2.1 per 1000 to 1.3) as underlying cause of death. The data reflect a high likelihood that cause-specific excess mortality is decreasing for men, and especially for women, with diabetes.

Keywords: Diabetes, Excess mortality, Selected causes of death