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

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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, Thompson, Theodore J., Herman, William H., the TRIAD Study Group*·2006·Diabetes Care

DOI 10.2337/diacare.29.02.06.dc05-0998

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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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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*
ORCID: McEwen, Laura N.
Kim, Catherine
Haan, Mary
Ghosh, Debashis
Mangione, Carol M.
Safford, Monika M.
Marrero, David
Thompson, Theodore J.
Herman, William H.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2006-02-01
Volume: 29
Issue: 2
Pages: 247-253
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/diacare.29.02.06.dc05-0998
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: bronze
doi.org
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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