Journal List > Korean Diabetes J > v.33(1) > 1002344

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Park, Park, Suk, Kim, Kim, Kim, Kang, Lee, Lee, Lee, Kim, Lee, Kim, and Kim: Cause-of-Death Trends for Diabetes Mellitus over 10 Years
Original Article
Korean Diabetes Journal

Korean Diabetes Journal 2009; 33(1): 65-72.

Published online: 28 February 2009

DOI: https://doi.org/10.4093/kdj.2009.33.1.65

Cause-of-Death Trends for Diabetes Mellitus over 10 Years

Su Kyung Park1, Mi-Kyoung Park1, Ji Hye Suk2, Mi Kyung Kim2, Yong Ki Kim3, In Ju Kim3, Yang Ho Kang3, Kwang Jae Lee4, Hyun Seung Lee4, Chang Won Lee5, Bo Hyun Kim5, Kyung Il Lee6, Mi Kyoung Kim6, Duk Kyu Kim1

1Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.

2Department of Endocrinology, Maryknoll Hospital, Busan, Korea.

3Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.

4Department of Endocrinology, Daedong Hospital, Busan, Korea.

5Department of Endocrinology, Busan St. Mary's Medical Center, Busan, Korea.

6Department of Endocrinology, Wallace Memorial Baptist Hospital, Busan, Korea.

dkkim@dau.ac.kr

Received 18 December 2008       Accepted 13 February 2009

Copyright © 2009 Korean Diabetes Association

Abstract

Background

Recently, diabetic mortality is lower than ever before, likely due to dramatic improvements in diabetes care. This study set to analyze changes in the cause of death in type 2 diabetes mellitus (T2DM) in the past 10 years.

Methods

All subjects were T2DM patients over the age of 30 whose death certificates were issued at six hospitals in the Busan metropolitan area from 2000 to 2004. The patients were excluded if they had been clinically diagnosed with significant tuberculosis, liver, thyroid, renal, connective tissue diseases and cancers, prior to T2DM diagnosis. We classified the cause of death into several groups by KCD-4. The results were compared with published data on the period from 1990 to 1994.

Results

The study comprised 680 patients, of which 374 (55.0%) were male. The average age of death was 66.3 ± 10.7 years. The most common cause of death was cardiovascular disease (30.6%), followed by infectious disease (25.3%), cancer (21.9%), congestive heart failure (7.1%), renal disease (4.7%), liver disease (2.7%), and T2DM itself (1.9%). In the study from the earlier period, the most common cause of death was also cardiovascular disease (37.6%), followed by infectious disease (24.2%), T2DM (6.0%), liver disease (5.4%), cancer (4.7%), and renal disease (3.3%).

Conclusion

Over both study periods, the first and second cause of death in T2DM were cardiovascular disease and infectious disease, respectively. However, death by cerebral infarction among cardiovascular disease patients was significantly lower in the latter period, while death by malignancy was markedly increased.

Keywords: Cause of death, Diabetes mellitus, Mortality

Figures and Tables

Fig. 1
The comparison of the proportion of the causes of death in the subjects between 1990~1994 and 2000~2004. *P < 0.001. CHF, congestive heart failure; CVD, cardiovascular disease; DM, diabetes mellitus; Etc, others; ID, infectious disease; LD, liver disease; Mal., malignancy; RD, renal disease.
kdj-33-65-g001
Fig. 2
Infectious causes of death in the subjects. The cause of death in sepsis (n = 106) can be divided as 'with DM foot' (n = 25) and 'without DM foot' (n = 81). DM, diabetes mellitus; Tbc, pulmonary tuberculosis.
kdj-33-65-g002
Table 1
The distribution of the subjects by age and sex
kdj-33-65-i001
Table 2
The proportion of cause of death in the subjects from 2000 through 2004
kdj-33-65-i002
Table 3
The comparison of causes of death in the subjects between 1990~1994 and 2000~2004
kdj-33-65-i003

*The data of the 1990's study was published in Korean Journal of Internal Medicine (50:530-6, 1996) and was presented again here for comparison after permission.

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