Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Oct 20, 2022
Open Peer Review Period: Oct 20, 2022 - Nov 3, 2022
Date Accepted: Jul 25, 2023
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Patterns and trends of mortality associated with and due to diabetes mellitus in a transitioning region with 3.17 million people: An observational study
ABSTRACT
Background:
Background:
Diabetes mellitus (DM) has a higher disease burden in transitioning regions and other transitioning regions are likely to experience urbanization processes similar to that of the Shanghai Pudong, which had been experiencing urbanization and is representative of a transitioning region.
Objective:
Objective:
To assess the burden and trends of DM mortality in the Shanghai Pudong and analyze the impact of aging and multimorbidity.
Methods:
Methods:
A longitudinal, population-based study was conducted to analyze DM mortality in the Shanghai Pudong from 2005 to 2020. We used the Joinpoint Regression Program to analyze the features of epidemiology and long-term trends of crude mortality rates (CMR), age-standardized mortality rates worldwide (ASMRW), and years of life lost (YLL). The decomposition method was used to evaluate the demographic and non-demographic factors associated with mortality.
Results:
Results:
There were 49,414 deaths among those with DM, including 15,512 deaths due to DM. The CMR and ASMRW were 109.55/105 and 38.01/105 person-years, respectively. Among the mortality associated with and due to DM, the total annual ASMRW increased by 3.65% (95% CI= (3.25, 4.06)%) and 1.38% (95% CI= (0.74, 2.02)%), the total annual YLL rates increased by 4.98% (95% CI= (3.92, 6.05)%) and 2.68% (95% CI= (1.34, 4.04)%). The YLL increasing rates of age group of 30-44 years [3.98% (95% CI= (0.32, 7.78)%)] and 45-59 years [4.31% (95% CI= (2.95, 5.69)%)] were followed by the age group of ≥80 years[10.53% (95% CI= (9.45, 11.62)%)] in the deaths associated with DM. The annual CMR attributable to demographic factors increased by 41.9% (95% CI= (17.73, 71.04)%) and 36.72% (95% CI= (16.69, 60.2)%) in deaths associated with and due to DM. Besides, hypertension, cerebrovascular disease and ischemic heart disease were the top 3 comorbidities.
Conclusions:
Conclusion: Aging and multimorbidity played essential roles in changing the burden of DM in an urbanizing and transitioning region. Health management as an emerging method with important implications for alleviating the future burden of DM.
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