Trend of diabetes mellitus related mortality in residents in Hangzhou, 2006−2020

  Objective   To analyze the mortality rate of diabetes melitus (DM) related death and its trend in residents in Hangzhou from 2006 to 2020, and to provide scientific basis for DM prevention and control.

  Methods  Through the medical certificate of death in hospitals at county level and above and community health service centers,the monitoring data of the death mentioning DM in Hangzhou from 2006 to 2020 were collected. The crude motality rates, standardized mortality rates were calculated. The proportion from DM specified complications were analyzed. The annual percentage change (APC) was used to examine the changing trend of the mortality.

  Results  The crude mortality rate and the standardized mortality rate of DM related death were 28.48/100 000 and 18.04/100 000 respectively in residents in Hangzhou from 2006 to 2020. The crude and standardized mortality rate from 2006 to 2020 showed increasing trends and the APC were 10.30% and 5.97% (P<0.001). The crude mortality rate was 27.71/100 000 in males,which was lower than 29.25/100 000 in females (χ²=21.608, P<0.001). The standardized mortality rate showed increasing trends in both males and females, the APC were 7.14% and 5.23%, respectively. The crude mortality rate of DM related death in Hangzhou increased gradually with age (χ²=60 754.086, P<0.001). The crude mortality rate in 45–54 years, 55–64 years and over 65 years groups showed upward trends (P<0.05). The standardized mortality rates were 20.66/10 000 in urban areas and 12.79/100 000 in rural areas (χ²=24 662.594, P<0.001), showing increasing trends, the APC were 6.08% and 6.61%, respectively. The proportions of specified complications including ketoacidosis, coma, renal complications, retinopathy, peripheral circulatory and multiple complications increased dramatically which collectively accounted for over 84.92% in the underlying death cause of DM.

  Conclusion  The mortality of DM related death and proportions of DM complications in residents in Hangzhou increased from 2006 to 2020. More efforts are needed to reduce DM related death in rural residents, males and elderly population.