The Changing Nature of Mortality and Morbidity in Patients with Diabetes
Open accessAbstract
The number of adults living with diabetes has increased substantially globally over the past 40 years, driven by a combination of increased age-standardized prevalence, population growth, aging, and increases in obesity prevalence. Patients with diabetes in high-income countries are living longer, with large declines in vascular disease mortality rates. This appears to be resulting in a diversification of cause of death, complications, and comorbidities that those with diabetes live with. This has large implications for prevention and management approaches, which should be reviewed to update the breadth of conditions that patients with diabetes are at excess risk of throughout their life. These trends have not yet been seen in low- and middle-income countries, where evidence is also more scarce.
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Although body mass index has a stronger association with type 2 diabetes than genetic risk scores, approximately 10% of individuals with type 2 diabetes do not have overweight or obesity.
“Although body mass index has a stronger association with type 2 diabetes than genetic risk scores,16 approximately 10% of individuals with type 2 diabetes do not have overweight or obesity.3”
From Diagnosis and Treatment of Type 2 Diabetes in Adults (2025) · cites this paper as [16]
Cites
Fox, C. S., Matsushita, K., Woodward, M., Bilo, H. J., Chalmers, J., Heerspink, H. J. L., Lee, B. J., Perkins, R. M., Rossing, P., Sairenchi, T., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61350-6 · Cited by 1,401 · see citing works
Gregg, E. W., Cheng, Y. J., Srinivasan, M., Lin, J., Geiss, L. S., Albright, A. L., & Imperatore, G. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30314-3 · Cited by 480 · see citing works
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Diagnosis and Treatment of Type 2 Diabetes in Adults
Kalyani, R. R., Neumiller, J. J., Maruthur, N. M., & Wexler, D. J. (2025) · JAMA · doi:10.1001/jama.2025.5956 · Cited by 145 · see citing works
- Authors
- Pearson-Stuttard, J., Buckley, J., Cicek, M., & Gregg, E. W.
- Affiliations
- MRC Centre for Environment and Health (GB)
- Imperial College London (GB)
- Venue
- Endocrinology and Metabolism Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2021-09
- Volume
- 50
- Issue
- 3
- Pages
- 357-368
- ISSN
- 0889-8529 (ISSN-L)
- OpenAlex
- W3194940383
- Cited by
- 48
- References
- 2
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 6 · 2023: 10 · 2022: 9 · 2021: 1
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Endocrinology and Metabolism Clinics of North America (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Spiral (Imperial College London) (submittedVersion, other-oa)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- Imperial College London (203928/Z/16/Z)
- Wellcome Trust (203928/Z/16/Z)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- diabetes mellitus, mortality trends, morbidity, vascular death, diabetes complications, comorbidities, obesity, aging, diabetes prevalence, causes of death, low- and middle-income countries, diabetes prevention and management
- MeSH terms
- Adult, Diabetes Mellitus, Humans, Morbidity, Mortality, Obesity, Prevalence
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