A nationwide analysis of the excess death attributable to diabetes in Brazil
Bibliographic Data
| ID | 19551544 |
|---|---|
| Authors | Paula A Bracco (0000-0001-6899-7386, Universidade Federal do Rio Grande do Sul, corresponding author), Edward W Gregg (0000-0003-2381-6822, Imperial College London), Deborah B Rolka (0000-0001-8732-8882, Diabetes Australia), Maria Ines Schmidt (0000-0002-3837-0731, Hospital de Clínicas de Porto Alegre), Sandhi Maria Barreto (0000-0001-7383-7811, Universidade Federal de Minas Gerais), Paulo A Lotufo (0000-0002-4856-8450, Universidade de São Paulo), Isabela Judith Martins Bensenor (0000-0002-6723-5678, Universidade de São Paulo), Isabela Benseñor, Dóra Chor (0000-0002-3941-5786, Fundação Oswaldo Cruz), Bruce B Duncan (0000-0002-7491-2630, Universidade Federal do Rio Grande do Sul) |
| Year | 2020 |
| Volume | 10 |
| Issue | 1 |
| Pages | 010401-010401 |
| Publication date | 2020-06-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Journal of Global Health (JOURNAL) |
| Journal identifiers | ISSN: 2047-2978 • E-ISSN: 2047-2986 |
| Publisher | International Society of Global Health (PUBLISHER • GB) |
| DOI | 10.7189/jogh.10.010401 |
| PMID | 32257151 |
| OpenAlex | W3009713435 |
| Language | EN |
| Citations received | 2 |
| References cited | 24 |
BACKGROUND: Data on mortality burden and excess deaths attributable to diabetes are sparse and frequently unreliable, particularly in low and middle-income countries. Estimates in Brazil to date have relied on death certificate data, which do not consider the multicausal nature of deaths. Our aim was to combine cohort data with national prevalence and mortality statistics to estimate the absolute number of deaths that could have been prevented if the mortality rates of people with diabetes were the same as for those without. In addition, we aimed to estimate the increase in burden when considering undiagnosed diabetes. METHODS: We estimated self-reported diabetes prevalence from the National Health Survey (PNS) and overall mortality from the national mortality information system (SIM). We estimated the diabetes mortality rate ratio (rates of those with vs without diabetes) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), an ongoing cohort study. Joining estimates from these three sources, we calculated for the population the absolute number and the fraction of deaths attributable to diabetes. We repeated our analyses considering both self-reported and unknown diabetes, the latter estimated based on single point-in-time glycemic determinations in ELSA-Brasil. Finally, we compared results with diabetes-related mortality information from death certificates. RESULTS: In 2013, 65 581 deaths, 9.1% of all deaths between the ages of 35-80, were attributable to known diabetes. If cases of unknown diabetes were considered, this figure would rise to 14.3%. In contrast, based on death certificates only, 5.3% of all death had diabetes as the underlying cause and 10.4% as any mentioned cause. CONCLUSIONS: In this first report of diabetes mortality burden in Brazil using cohort data to estimate diabetes mortality rate ratios and the prevalence of unknown diabetes, we showed marked underestimation of the current burden, especially when unknown cases of diabetes are also considered
Attributable risk · Cause of death · Cohort · Cohort study · Death certificate · Diabetes mellitus · Disease · Environmental health · Mortality rate · National Health and Nutrition Examination Survey · Population · Autopsy Techniques and Outcomes · Demography · Diabetes, Cardiovascular Risks, and Lipoproteins · Medical Coding and Health Information · Medicine · Endocrinology · Gerontology · Internal Medicine
| Citations per year | 0.4 |
|---|---|
| Citation span | 2021 - 2025 (5) |
| Highly cited | No |