Abstract

Objective: We sought to explore the conditions driving the diversification in causes of death among people with diabetes. Methods: We linked Australians with type 1 or type 2 diabetes of all ages on the National Diabetes Services Scheme (Diabetes Registry) to the National Death Index for 2002-2019. We investigated causes of death over time across eight categories of causes of death. Underlying causes of death were classified according to the International Classification of Diseases, Tenth Revision codes. Results: Between 2002-2019, there was a shift in the underlying cause of death among Australians with diabetes. The proportion of deaths attributed to cardiovascular disease declined in both sexes (Ptrend < 0.001), most substantially among females with type 2 diabetes from 48.2% in 2002 to 30.7% in 2019 (Figure). Among males, cancer overtook cardiovascular disease as the leading cause of death. The proportion of deaths due to dementia increased among all people with diabetes, from 2% in 2002 to 7% in 2019, across all age-groups, notably from 1% to 4% in those aged 70-79. The proportion of deaths due to falls also increased. Conclusions: We are seeing a shift of causes of death among those with diabetes away from cardiovascular and renal disease towards conditions such as dementia, falls, and respiratory disease, which may have serious consequences for health systems and will require consideration in resource allocation. Disclosure D.Tomic: None. L.Chen: None. D.J.Magliano: None. J.E.Shaw: Advisory Panel; Abbott Diagnostics, Lilly, Zuellig Pharma Holdings Pte. Ltd., Mylan, Research Support; AstraZeneca, Speaker's Bureau; AstraZeneca, Roche Diagnostics, Lilly, Amgen Inc., Sanofi, Zuellig Pharma Holdings Pte. Ltd.

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