The Burden of Mortality Attributable to Diabetes

Realistic estimates for the year 2000

  1. Gojka Roglic, MD1,
  2. Nigel Unwin, DM, MFPH1,
  3. Peter H. Bennett, MB, FRCP2,
  4. Colin Mathers, BSC, PHD3,
  5. Jaakko Tuomilehto, MD, PHD456,
  6. Satyajit Nag, MRCP7,
  7. Vincent Connolly, MD, FRCP7 and
  8. Hilary King, MD, DSC1
  1. 1Department of Chronic Diseases and Health Promotion, World Health Organization, Geneva, Switzerland
  2. 2National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona
  3. 3Measurement and Health Information, World Health Organization, Geneva, Switzerland
  4. 4Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
  5. 5Department of Public Health, University of Helsinki, Helsinki, Finland
  6. 6South Ostrobotnia Central Hospital, Seinäjoki, Finland
  7. 7Diabetes Care Centre, The James Cook University Hospital, Middlesborough, U.K.
  1. Address correspondence and reprint requests to Dr. Gojka Roglic, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. E-mail: roglicg{at}


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.


  • Additional information for this article can be found in an online appendix at

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    See accompanying editorial, p. 2320.

    • Accepted May 8, 2005.
    • Received January 19, 2005.
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