Abstract
BackgroundMortality from acute complications of diabetes, a predominantly preventable condition, although controlled in high income countries, remains a major challenge for low/middle income countries. The aim of this study is to describe trends in mortality from acute complications of diabetes between 1991 and 2010 in Brazil, a period during which a national health system was implemented offering broad access to diabetes treatment.MethodsWe obtained the number of deaths listed in the Brazilian Mortality Information System between 1991 and 2010 as due to acute complications of diabetes (ICD-9 250.1, .2, or .3 and ICD-10 E10–14.0 or 1), corrected this number for ill-defined causes of death and incompleteness in mortality reporting, and calculated mortality rates standardized to the world’s population. We describe mortality trends with Joinpoint regressions.ResultsOver this 20 year period, mortality due to the acute complications of diabetes fell 70.9 % (95 % CI 67.2 to 74.5 %), from 8.42 (95 % CI 8.27 to 8.57) deaths per 100000 inhabitants in 1991 to 2.45 (95 % CI 2.38 to 2.52) per 100000 in 2010. The reduction occurred in men and women, in all age groups, and in all regions of Brazil.ConclusionsMortality from acute complications of diabetes in Brazil has declined markedly in parallel with the implementation of a national health system providing access to insulin and organization of health care. Further decline is possible and necessary.
Highlights
Mortality from acute complications of diabetes, a predominantly preventable condition, controlled in high income countries, remains a major challenge for low/middle income countries
The aim of this study is to evaluate trends in mortality in Brazil due to the acute complications of diabetes, starting from 1991, shortly after Brazil’s national health system was implemented, and covering a period during which health care for diabetes has been progressively organized
Over the 1991–2010 period, 694769 deaths occurred due to diabetes in Brazil, of which 81208 (11.7 %) were due to acute complications
Summary
Mortality from acute complications of diabetes, a predominantly preventable condition, controlled in high income countries, remains a major challenge for low/middle income countries. The aim of this study is to describe trends in mortality from acute complications of diabetes between 1991 and 2010 in Brazil, a period during which a national health system was implemented offering broad access to diabetes treatment. Evaluation of Klafke et al BMC Public Health (2015) 15:772 trends during this period in relevant outcomes related to diabetes has rarely been done In this regard, the prevention of death from acute complications of diabetes is of major importance to low/middle income countries, since, in principle, these deaths are almost entirely preventable (especially before age 40) [10]. The relative simplicity of monitoring these deaths provides an important yardstick for gauging the results of actions to prevent and control diabetes
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