Cited by 127Medical Coding and Health InformationDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and Research

Diabetes Reporting as a Cause of Death

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McEwen, Laura N., Kim, Catherine, Haan, Mary, Ghosh, Debashis, Lantz, Paula M., Mangione, Carol M., Safford, Monika M., Marrero, David +3 more·2006·Diabetes Care

Abstract

OBJECTIVE—To determine the frequency of reporting of diabetes on death certificates of decedents with known diabetes, define factors associated with reporting of diabetes, and describe trends in reporting over time. RESEARCH DESIGN AND METHODS—Data were obtained from 11,927 participants with diabetes who were enrolled in the Translating Research Into Action for Diabetes study, a multicenter prospective observational study of diabetes care in managed care. Data on decedents (n = 540) were obtained from the National Death Index. The primary dependent variable was the presence of ICD-10 codes for diabetes on the death certificate. Covariates included age at death, sex, race/ethnicity, education, income, duration of diabetes, type of diabetes, diabetes treatment, smoking status, and number of comorbidities. RESULTS—Diabetes was recorded on 39% of death certificates and as the underlying cause of death for 10% of decedents with diabetes. Diabetes was significantly less likely to be reported on the death certificates of decedents with diabetes dying of cancer. Predictors of recording diabetes anywhere on the death certificate included longer duration of diabetes and insulin treatment. Longer duration of diabetes, insulin treatment, and fewer comorbidities were associated with recording of diabetes as the underlying cause of death. CONCLUSIONS—Diabetes is much more likely to be reported on the death certificates of diabetic individuals who die of cardiovascular causes. Reporting of diabetes on death certificates has been stable over time. Death certificates underestimate the prevalence of diabetes among decedents and present a biased picture of the causes of death among people with diabetes.

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Crossref · 10.2337/diacare.29.02.06.dc05-0998

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Authors
McEwen, L. N., Kim, C., Haan, M., Ghosh, D., Lantz, P. M., Mangione, C. M., Safford, M. M., Marrero, D., Thompson, T. J., Herman, W. H., & the TRIAD Study Group*
Affiliations
  • University of Michigan (US)
  • University of California, Los Angeles (US)
  • University of Alabama at Birmingham (US)
  • Indiana University School of Medicine (US)
  • Centers for Disease Control and Prevention (US)
Corresponding author
the TRIAD Study Group*
Venue
Diabetes Care
Published
2006-02-01
Volume
29
Issue
2
Pages
247-253
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
OpenAlex
W2103367054
Cited by
127
References
33
Citations by year
2026: 3 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 8 · 2021: 8 · 2020: 2 · 2019: 4 · 2018: 3 · 2017: 5 · 2016: 10 · 2015: 5 · 2014: 11 · 2013: 8 · 2012: 5
FWCI
20.46
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Centers for Disease Control and Prevention (04005)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P60DK020572, 04005)
Topics
  • Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
diabetes mellitus, death certificates, causes of death, underlying cause of death, diabetes duration, insulin therapy, comorbidities, cancer mortality, cardiovascular mortality, mortality trends, ICD-10 codes
MeSH terms
Cause of Death, Death Certificates, Diabetes Mellitus, Female, Humans, Male, Prospective Studies, United States, Comorbidity, Multivariate Analysis, Odds Ratio

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