Year of birth and mortality caused by diabetes mellitus under 45 years: England and Wales 1927–1986

Abstract

It has been suggested that mortality caused by diabetes under 45 years of age could be used to monitor the effectiveness of health care for people with diabetes. We report an age-period-cohort analysis of mortality from diabetes which was designed to evaluate effects of short- and longer-term influences on diabetes mortality. Mortality increased with age and in general decreased with advancing time period, but in the age group 40-44 years mortality showed a steep rise between the years 1952 and 1972 which was greater in men than women (increment: 13.1-29.5 per million in men; 9.8-17.9 per million in women). This increment was associated with a cohort effect which was significant in men but not in women. The relation of these findings to the results of prospective studies reported from Denmark are discussed. In this chronic disease contemporary mortality results from a number of influences acting over many years so that interpretation of this proposed indicator would not be straightforward.