posted 11/01/02
At least 3.6% of all deaths and 5.2% of cardiovascular disease
(CVD) deaths in US adults are attributable to diabetes.
"Diabetes is a well-established cause of CVD and
all-cause mortality," Dr. Frederick L. Brancati, of Johns Hopkins University,
Baltimore, Maryland, and colleagues note. "The burden of death attributable to
diabetes in the United States is not well quantified, particularly with regard
to age."
The researchers examined data from the Second
National Health and Nutrition Examination Survey (NHANES II) and the NHANES II
Mortality Study in order to determine all-cause and cause-specific mortality. A
cohort of 9250 adults was followed for 12 to 16 years.
Between 1976 and 1980, the overall prevalence of
diagnosed diabetes was 4.3%. The relative hazard of all-cause mortality was 1.9
by 1992. The population-attributable risk (PAR) was 3.6%.
The relative hazard of CVD mortality by 1992 was
2.3. The PAR was 5.2%. When subjects with undiagnosed diabetes were included in
the analysis, the PAR for all-cause and CVD mortality were increased to 5.1% and
6.8%, respectively.
The prevalence of diagnosed diabetes was higher
among women than among men (4.7% versus 3.8%, p < 0.05). Diabetic women had a
greater relative hazard of death than nondiabetic women. This led to a higher
PAR for women (3.8% for all causes and 7.3% for CVD) versus men (3.3% for all
causes and 3.8% for CVD).
"These results indicate that improvements in the treatment and prevention of diabetes may postpone these deaths and have an impact on life expectancy in the United States, even at older ages," Dr. Brancati and colleagues explain. "This study suggests a need for research on barriers to and facilitators of treatment for people with diabetes and the development of approaches that promote cooperation by patients with their treatment regimen."
Source: Diabetes In Control Dot Com: Am J Epidemiology 2002;156:714-719.
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