Estimates of deaths from Diabetes suggest that it may a leading cause of death worldwide, researchers report. In 2000, approximately 2.9 million died of Diabetes, about three times that of previous estimates.

“Diabetes is a significant cause of death in adults of working age, even in low-income countries where diabetes is often not recognized as a public health problem,” said lead investigator Dr. Gojka Roglic, of the World Health Organization in Geneva. “This fact is not captured in existing national or global health statistical reports, which are used for planning interventions and allocating resources.”

In their report, published in the journal Diabetes Care, Roglic and colleagues note that most international mortality statistics rely on the underlying cause of death as recorded on the death certificate. However, this approach has limitations and more sophisticated methods have been developed and applied to estimate cause-specific deaths for AIDS, Tuberculosis and other diseases, but not Diabetes.

To estimate cause-specific deaths for Diabetes, the researchers used a computerized disease model that assessed disease burden using a variety of relationships, including age, sex and disease-specific mortality. They also used population-based observations and other independent methods.

The researchers estimated that overall, 7.5 million people with Diabetes died in 2000. This included 4.6 million people with Diabetes who died from other causes and 2.9 million deaths due to Diabetes. Of these deaths, 1 million occurred in developing countries and 1.9 million occurred in developed nations.

The lowest proportion of deaths (2.4 percent) was seen in the poorest African countries and in Cambodia, Laos, Myanmar and Vietnam. It was highest (9 percent) in the Arabian Peninsula and the Americas (8.5 percent).

Overall in 2000, the proportion of deaths from Diabetes worldwide was 5.2 percent. An earlier WHO estimate using routine statistics came up with a corresponding figure of 1.7 percent for 2002.

Given the revised estimates, the researchers conclude that “globally, Diabetes is likely to be the fifth leading cause of death.”

In an accompanying editorial, Dr. Edward J. Boyko of the University of Washington, Seattle, notes the study indicates an “important direction” in development of information on the subject. “Better data and more thorough analyses should soon enhance our understanding of the worldwide impact of diabetes on mortality.”

SOURCE: Diabetes Care, September 2005.