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Member Research & Reports

Member Research & Reports

BU: US Deaths from Diabetes Significantly Underestimated

The proportion of deaths attributable to diabetes in the US is as high as 12 percent—three times higher than estimates based on death certificates suggest, according to a new analysis led by a Boston University School of Public Health (BUSPH) researcher.

The study, published in the journal PLOS ONE, used two large data sets that included more than 300,000 people to estimate the fraction of deaths attributable to diabetes among individuals ages 30 to 84 between 1997 and 2011. To come up with the estimates, the researchers calculated the prevalence of diabetes in the population, as well as excess mortality risk among people with diabetes over five years of follow up.

The proportion of deaths attributable to diabetes was estimated to be 11.5 percent using one dataset—the National Health Interview Study (NHIS)—and 11.7 percent using the other, the National Health and Nutrition Examination Survey (NHANES). Among the subgroups examined, the attributable fraction was highest among individuals with obesity (19.4 percent). The proportion of deaths overall was significantly higher than the 3.3 to 3.7 percent of deaths in which diabetes is identified on death certificates as the underlying cause.

“The frequency with which diabetes is listed as the underlying cause of death is not a reliable indicator of its actual contribution to the national mortality profile,” wrote Dr. Andrew Stokes, assistant professor of global health at BUSPH, and co-author Dr. Samuel Preston, professor of sociology and a researcher with the Population Studies Center at the University of Pennsylvania.

To read more about the study, go to: