Temporal trends in recording of diabetes on death certificates: Results from Translating Research into Action for Diabetes (TRIAD)

Laura N. McEwen, Andrew J. Karter, J. David Curb, David G. Marrero, Jesse C. Crosson, William H. Herman

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

OBJECTIVE - To determine the frequency that diabetes is reported on death certificates of decedents with known diabetes and describe trends in reporting over 8 years. RESEARCH DESIGN AND METHODS - Data were obtained from 11,927 participants with diabetes who were enrolled in Translating Research into Action for Diabetes, a multicenter prospective observational study of diabetes care in managed care. Data on decedents (N = 2,261) were obtained from the National Death Index from 1 January 2000 through 31 December 2007. The primary dependent variables were the presence of the ICD-10 codes for diabetes listed anywhere on the death certificate or as the underlying cause of death. RESULTS - Diabetes was recorded on 41% of death certificates and as the underlying cause of death for 13% of decedents with diabetes. Diabetes was significantly more likely to be reported on the death certificate of decedents dying of cardiovascular disease than all other causes. There was a statistically significant trend of increased reporting of diabetes as the underlying cause of death over time (P < 0.001), which persisted after controlling for duration of diabetes at death. The increase in reporting of diabetes as the underlying cause of death was associated with a decrease in the reporting of cardiovascular disease as the underlying cause of death (P < 0.001). CONCLUSIONS - Death certificates continue to underestimate the prevalence of diabetes among decedents. The increase in reporting of diabetes as the underlying cause of death over the past 8 years will likely impact estimates of the burden of diabetes in the U.S.

Original languageEnglish (US)
Pages (from-to)1529-1533
Number of pages5
JournalDiabetes care
Volume34
Issue number7
DOIs
StatePublished - Jul 1 2011

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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