Please use this identifier to cite or link to this item: http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/7872
Diabetes-related excess mortality in Mexico: a comparative analysis of national death registries between 2017-2019 and 2020
Daniel Ramírez García
Omar Yaxmehen Bello-Chavolla
Neftali Eduardo Antonio Villa
Luisa Fernández Chirino
Carlos Fermín Martínez
Arsenio Vargas Vázquez
Martín Roberto Basile Alvarez
Ana Elena Hoyos-Lázaro
Rodrigo M. Carrillo-Larco
Jacqueline Seiglie
Jennifer Manne-Goehler
Deborah Wexler
Acceso Abierto
Atribución-NoComercial-SinDerivadas
https://doi.org/10.1101/2022.02.24.22271337
ACKGROUND Excess all-cause mortality rates in Mexico in 2020 during the COVID-19 pandemic were among the highest globally. Recent reports suggest that diabetes-related deaths were also higher, but the contribution of diabetes as a cause of excess mortality in Mexico during 2020 compared to prior years has not yet been characterized. METHODS We conducted a retrospective, state-level study using national death registries from Mexican adults ≥20 years for the 2017-2020 period. Diabetes-related deaths were classified using ICD-10 codes that listed diabetes as the primary cause of death, excluding certificates which listed COVID-19 as a cause of death. Excess mortality was estimated as the increase in diabetes-related mortality in 2020 compared to average rates in 2017-2019. Analyses were stratified by diabetes type, diabetes-related complication, and in-hospital vs. out-of-hospital death. We evaluated the geographic distribution of diabetes-related excess mortality and its socio-demographic and epidemiologic correlates using spatial analyses and negative binomial regression models. RESULTS We identified 148,437 diabetes-related deaths in 2020 (177/100,000 inhabitants), 41.6% higher than the average for 2017-2019, with the excess occurring after the onset of the COVID-19 pandemic. In-hospital diabetes-related deaths decreased by 17.8% in 2020 compared to 2017-2019, whereas out-of-hospital deaths increased by 89.4%. Most deaths were attributable to type 2 diabetes and type 1 diabetes (129.7 and 4.0/100,000 population). Diabetes-related emergencies as contributing causes of death also increased in 2020 compared to 2017-2019 for hyperglycemic hyperosmolar state (128%), and ketoacidosis (116%). Diabetes-related excess mortality clustered in southern Mexico and was highest in states with higher social lag, higher rates of COVID-19 hospitalization, and higher prevalence of HbA1c ≥7.5%. INTERPRETATION Diabetes-related mortality increased among Mexican adults by 41.6% in 2020 after the onset of the pandemic compared to 2017-2019, largely attributable to type 2 diabetes. Excess diabetes-related deaths occurred disproportionately out-of-hospital, clustered in southern Mexico, and were associated with higher state-level marginalization, rates of COVID-19 hospitalizations, and higher prevalence of suboptimal glycemic control. Urgent policies to mitigate mortality due to diabetes in Mexico are needed, particularly given the ongoing challenges in caring for people with di
Medrxiv
25-02-2022
Preimpreso
medrxiv.org/
VIRUS RESPIRATORIOS
Appears in Collections:Artículos científicos

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