Death from Diabetes: Three Times More Likely Than Once Thought

About 12 percent of Americans might be dying from diabetes, despite what has been reported on death certificates, Boston University study finds.

Diabetes is a known killer, but just how deadly the disease is has been vastly under reported, according to Boston University researchers.

Diabetes, which affects almost 30 million Americans, occurs when the body has a difficult time processing sugars with insulin, the hormone that helps the body transfer sugar into cells for use. When too much sugar remains in the blood, complications such as kidney disease, nerve damage and heart disease can occur. Type 1 diabetes is when the body does not produce insulin at all, while type 2 diabetes occurs when insulin does not function properly. Diabetes can be treated with lifestyle changes, like a healthier diet, and managed with supplementing insulin for more dire cases.

In this study, researchers from the BU School of Public Health used data from about 300,000 people who partook in the National Health Interview Survey, a yearly survey conducted by the Centers for Disease Control and Prevention. The researchers found that because of a variety of diseases that are caused by diabetes, death certificates have not been accurate when it comes to citing diabetes as a cause of death.

“When diabetes started 10 to 30 or more years before a patient died, the disease may not be in the forefront of the attending physician at time of death,” Catherine Cowie, an epidemiologist at the National Institute of Diabetes and Digestive and Kidney Diseases who was not involved in the study, told the Washington Post.

This discrepancy could mean that diabetes is the third leading cause of death in the US, as opposed to the seventh, as once thought, the study reports.

“We argue diabetes is responsible for 12 percent of deaths in the U.S., rather than 3.3 percent that death certificates indicate,” lead study author Andrew Stokes, assistant professor of global health, said to the Washington Post.

Stokes and team found that when it comes to reporting diabetes as a cause of death, a variety of factors influence the decision, including “race and sex, whether the death occurs in a hospital, and the number of cardiologists per capita in the area.”

The researchers suggest that it would be more accurate to consider the higher risk of death among those who have diabetes and the actual number of people who are likely to have the disease.

According to Stokes and team, these new findings indicate that the US has a need for for “robust population-level interventions aimed at diabetes prevention and care.”

This study was published January 25th in the journal PLOS ONE.

This study was funded by the National Institute on Aging and the National Center for Health Statistics.

No conflicts of interest were reported.

Sources:
BU School of Public Health, “US Deaths from Diabetes Significantly Underestimated”
https://www.bu.edu/sph/2017/01/25/us-deaths-from-diabetes-significantly-underestimated/
CDC.gov, “National Health Interview Survey”
https://www.cdc.gov/nchs/nhis/
NIH, “Diabetes”
https://medlineplus.gov/diabetes.html
PLOS ONE, “Deaths Attributable to Diabetes in the United States: Comparison of Data Sources and Estimation Approaches”
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0170219
Washington Post, “Diabetes is even deadlier than we thought, study suggests”
https://www.washingtonpost.com/national/health-science/diabetes-is-even-deadlier-than-we-thought-study-suggests/2017/04/07/28689b94-faca-11e6-be05-1a3817ac21a5_story.html?utm_term=.411fe8d1cbeb&wpisrc=nl_sb_smartbrief