Characteristics of the causes of death in patients with diabetes mellitus receiving recent standard medical care: A cross-sectional comparison with non-diabetes patients in the last 10 years

Abstract

Abstract Background Diabetes treatment aims to prevent complications and help patients lead a healthy life comparable to individuals without diabetes. The age at death of individuals with diabetes has been reported to be lower than that of those without diabetes. Therefore, we aimed to analyze the differences in the age at death and the cause of death between individuals with and without diabetes. Methods We retrospectively analyzed 9,627 adult patients who died at St. Marianna University Hospital (Kawasaki, Japan) using electronic medical record data collected between January 2011 and December 2020. We extracted data on sex, age at death, the International Classification of Diseases, 10th revision codes for cause of death, and the presence or absence of diabetes. The Chi-square test was performed to compare the causes of death between patients with and without diabetes. Results Of the 9,627 patients, 836 (8.7%) were diagnosed with diabetes. The median age at death [interquartile range] of patients with and without diabetes was 76.0 [65.0, 84.0] years and 75.5 [68.0, 81.0], respectively. The median age at death was not significantly different between the two groups (P = 0.570). The distribution of the peak age at death was in the 70s for patients with diabetes and lower than the 80s for those without diabetes. Regarding the cause of death in patients with diabetes, malignant neoplasia (38.4%) ranked first, followed by infection (12.4%), cerebrovascular disease (5.6%), and cardiovascular disease (5.1%). Among the causes of death, malignant neoplasia, infection, and cerebrovascular disease were significantly more common in patients with diabetes than in those without diabetes. In contrast, the incidence of cardiovascular disease did not differ between the two groups. Conclusions The difference in age at death between patients with diabetes and those without diabetes has recently narrowed. No significant difference was observed in the median age of death, although the peak of the age distribution at death was higher in patients with diabetes. Early diagnosis and the treatment of complications and comorbidities, including malignant neoplasms (particularly lung, liver, pancreas, leukemia, and lymphoma), infections, and cerebrovascular disease (particularly cerebral infarction), are important for achieving diabetes treatment goals.