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Diabetes Care 28:2130-2135, 2005
© 2005 by the American Diabetes Association, Inc.

Epidemiology/Health Services/Psychosocial Research
Original Article

The Burden of Mortality Attributable to Diabetes

Realistic estimates for the year 2000

Gojka Roglic, MD1, Nigel Unwin, DM, MFPH1, Peter H. Bennett, MB, FRCP2, Colin Mathers, BSC, PHD3, Jaakko Tuomilehto, MD, PHD4,5,6, Satyajit Nag, MRCP7, Vincent Connolly, MD, FRCP7 and Hilary King, MD, DSC1

1 Department of Chronic Diseases and Health Promotion, World Health Organization, Geneva, Switzerland
2 National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona
3 Measurement and Health Information, World Health Organization, Geneva, Switzerland
4 Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
5 Department of Public Health, University of Helsinki, Helsinki, Finland
6 South Ostrobotnia Central Hospital, Seinäjoki, Finland
7 Diabetes Care Centre, The James Cook University Hospital, Middlesborough, U.K.

Address correspondence and reprint requests to Dr. Gojka Roglic, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. E-mail: roglicg{at}who.int

OBJECTIVE—To estimate the global number of excess deaths due to diabetes in the year 2000.

RESEARCH DESIGN AND METHODS—We used a computerized generic formal disease model (DisMod II), used by the World Health Organization to assess disease burden through modeling the relationships between incidence, prevalence, and disease-specific mortality. Baseline input data included population structure, age- and sex-specific estimates of diabetes prevalence, and available published estimates of relative risk of death for people with diabetes compared with people without diabetes. The results were validated with population-based observations and independent estimates of relative risk of death.

RESULTS—The excess global mortality attributable to diabetes in the year 2000 was estimated to be 2.9 million deaths, equivalent to 5.2% of all deaths. Excess mortality attributable to diabetes accounted for 2–3% of deaths in poorest countries and over 8% in the U.S., Canada, and the Middle East. In people 35–64 years old, 6–27% of deaths were attributable to diabetes.

CONCLUSIONS—These are the first global estimates of mortality attributable to diabetes. Globally, diabetes is likely to be the fifth leading cause of death.

Abbreviations: DECODA, Diabetes Epidemiology, Collaborative Analysis of Diagnostic Criteria in Asia • DECODE, Diabetes Epidemiology, Collaborative Analysis of Diagnostic Criteria in Europe • WHO, World Health Organization


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