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The burden of diabetes-related mortality in France in 2002: an analysis using both underlying and multiple causes of death

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Abstract

Aim To describe the burden of diabetes-related mortality in France. Methods Underlying and multiple causes (all causes listed) of death were extracted from the 2002 French national mortality registry. Death rates were standardized on the age structure of the European population. Results Diabetes was reported as the underlying cause of death in 11,177 certificates (2.1%), and as multiple causes in 29,357 certificates (5.3%), giving a ratio (multiple/underlying causes) of 2.6. When diabetes was a multiple cause, the mean age at death was 75 years in men, 81 years in women. The age-standardized mortality rates were 41.0/100,000 in men, 24.6/100,000 in women. The excess mortality observed in men (men/women ratio = 1.7) decreased with age. Geographic differences were observed: higher rates in the North-East, lower rates in the West of the country. In certificates mentioning diabetes, the most frequent cause of death was diseases of the circulatory system (76%). Coronary heart diseases, foot ulcers and renal diseases were more likely to be mentioned in certificates referring to diabetes than in those that did not. Discussion The use of multiple rather than underlying causes of death more than doubled diabetes-related mortality rates. While probably still under-estimated, the burden of diabetes-related mortality corresponds to a high proportion of the total mortality, especially in men. Geographic differences partially reflect disparities in diabetes prevalence. Causes more frequently associated with diabetes include coronary heart disease and complications related to neuropathy and nephropathy.

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Abbreviations

ICD-10:

10th International Classification of Disease

CI:

Confidence interval

RR:

Relative risk

WHO:

World Health Organization

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Acknowledgements

We thank Cleo Rooney and Anita Brock (research officers in the mortality statistics, United-Kingdom), Kenneth D. Kochaneck (National center for health statistics, USA), Lars Age Johansson (Statistics Sweden), Isabelle Laroque (National institute of public health of Québec, Canada), who provided figures in diabetes-related mortality for their own countries.

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Authors and Affiliations

  1. French Institute for Public Health Surveillance, Institut de Veille Sanitaire (InVS), 12 rue du Val d’Osne, 94415, Saint-Maurice Cedex, France

    Isabelle Romon & Anne Fagot-Campagna

  2. French Institute of Health and Medical Research, Inserm-Cépidc, Le Vesinet, France

    Eric Jougla

  3. French Institute of Health and Medical Research, Inserm U780, Villejuif, France

    Beverley Balkau

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  1. Isabelle Romon
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  2. Eric Jougla
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  4. Anne Fagot-Campagna
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Correspondence to Isabelle Romon.

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Romon, I., Jougla, E., Balkau, B. et al. The burden of diabetes-related mortality in France in 2002: an analysis using both underlying and multiple causes of death. Eur J Epidemiol 23, 327–334 (2008). https://doi.org/10.1007/s10654-008-9235-5

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