Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2011 Jul;34(7):1529-33.
doi: 10.2337/dc10-2312.

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

Laura N McEwen  1 , Andrew J Karter, J David Curb, David G Marrero, Jesse C Crosson, William H Herman
Affiliations
Multicenter Study

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

Laura N McEwen et al. Diabetes Care. 2011 Jul.

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Top panels: Percent recording of diabetes as the underlying cause of death and anywhere on the death certificate by year of death, 2001–2007. Bottom panels: Percent recording of diabetes as the underlying cause of death and anywhere on the death certificate stratified by year of death and duration of diabetes at death, 2001–2007.
Figure 2
Figure 2
Distribution of underlying cause of death by year of death, 2001–2007.
See this image and copyright information in PMC

References

    1. Heron M, Tejada-Vera B. Deaths: leading causes for 2005. Natl Vital Stat Rep 2009;58:1–97 - PubMed
    1. Will JC, Vinicor F, Stevenson J. Recording of diabetes on death certificates. Has it improved? J Clin Epidemiol 2001;54:239–244 - PubMed
    1. Thomason MJ, Biddulph JP, Cull CA, Holman RR. Reporting of diabetes on death certificates using data from the UK Prospective Diabetes Study. Diabet Med 2005;22:1031–1036 - PubMed
    1. Cheng WS, Wingard DL, Kritz-Silverstein D, Barrett-Connor E. Sensitivity and specificity of death certificates for diabetes: as good as it gets? Diabetes Care 2008;31:279–284 - PMC - PubMed
    1. McEwen LN, Kim C, Haan M, et al. ; TRIAD Study Group Diabetes reporting as a cause of death: results from the Translating Research Into Action for Diabetes (TRIAD) study. Diabetes Care 2006;29:247–253 - PubMed

Publication types