Diabetes-related excess mortality in Mexico: a comparative analysis of National Death Registries between 2017-2019 and 2020
File(s)Diabetes Care Paper - Omar.pdf (1.94 MB)
Accepted version
Author(s)
Type
Journal Article
Abstract
OBJECTIVE: To estimate diabetes-related mortality in Mexico in 2020 compared with 2017-2019 after the onset of the coronavirus disease 2019 (COVID-19) pandemic. RESEARCH DESIGN AND METHODS: This retrospective, state-level study used national death registries of Mexican adults aged ≥20 years for the 2017-2020 period. Diabetes-related death was defined using ICD-10 codes listing diabetes as the primary cause of death, excluding certificates with COVID-19 as the primary cause of death. Spatial and negative binomial regression models were used to characterize the geographic distribution and sociodemographic and epidemiologic correlates of diabetes-related excess mortality, estimated as increases in diabetes-related mortality in 2020 compared with average 2017-2019 rates. RESULTS: We identified 148,437 diabetes-related deaths in 2020 (177 per 100,000 inhabitants) vs. an average of 101,496 deaths in 2017-2019 (125 per 100,000 inhabitants). In-hospital diabetes-related deaths decreased by 17.8% in 2020 versus 2017-2019, whereas out-of-hospital deaths increased by 89.4%. Most deaths were attributable to type 2 diabetes (130 per 100,000 inhabitants). Compared with 2018-2019 data, hyperglycemic hyperosmolar state and diabetic ketoacidosis were the two contributing causes with the highest increase in mortality (128% and 116% increase, respectively). Diabetes-related excess mortality clustered in southern Mexico and was highest in states with higher social lag, rates of COVID-19 hospitalization, and prevalence of HbA1c ≥7.5%. CONCLUSIONS: Diabetes-related deaths increased among Mexican adults by 41.6% in 2020 after the onset of the COVID-19 pandemic, occurred disproportionately outside the hospital, and were largely attributable to type 2 diabetes and hyperglycemic emergencies. Disruptions in diabetes care and strained hospital capacity may have contributed to diabetes-related excess mortality in Mexico during 2020.
Date Issued
2022-10-26
Online Publication Date
2022-11-08T09:33:41Z
Date Acceptance
2022-09-27
ISSN
0149-5992
Publisher
American Diabetes Association
Start Page
2957
End Page
2966
Journal / Book Title
Diabetes Care
Volume
45
Issue
12
Copyright Statement
© 2022 by the American Diabetes Association.
Identifier
https://diabetesjournals.org/care/article/45/12/2957/147830/Diabetes-Related-Excess-Mortality-in-Mexico-A
https://www.ncbi.nlm.nih.gov/pubmed/36286591
147830
Publication Status
Published
Country
United States
Date Publish Online
2022-10-26