Causes of death in Japanese patients with diabetes based on the results of survey of 68,555 cases during 2011-2020: committee report on causes of death in diabetes mellitus, Japan Diabetes Society (English version).

IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Diabetology International Pub Date : 2024-10-04 eCollection Date: 2024-10-01 DOI:10.1007/s13340-024-00736-3
Jiro Nakamura, Narihito Yoshioka, Hideki Katagiri, Kohjiro Ueki, Toshimasa Yamauchi, Nobuya Inagaki, Yukio Tanizawa, Eiichi Araki, Takeo Nakayama, Hideki Kamiya
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Abstract

The principal causes of death among 68,555 patients with diabetes and 164,621 patients without diabetes who died in 208 hospitals throughout Japan between 2011 and 2020 were determined based on a survey of hospital records. 1. The most frequent cause of death in patients with diabetes was malignant neoplasms (38.9%) (lung 7.8%, pancreas 6.5%, liver 4.1%), followed, in order of descending frequency, by infectious diseases (17.0%) and then vascular diseases (10.9%) (cerebrovascular diseases 5.2%, ischemic heart diseases 3.5%, renal failure 2.3%). The proportion of deaths from malignant neoplasms and vascular diseases has trended upward and downward, respectively. Almost all deaths from ischemic heart diseases were due to myocardial infarction, and the proportion of deaths from heart diseases other than ischemic heart diseases was relatively high (9.0%), with most cases due to heart failure. Diabetic coma associated with hyperglycemia accounted for only 0.3% of deaths. 2. The proportion of deaths from malignant neoplasms, infectious diseases, renal failure, ischemic heart diseases, and heart failure was significantly higher in patients with diabetes than in those without diabetes, and the proportion of deaths from cerebrovascular diseases was significantly lower in patients with diabetes. 3. In regard to the relationship between the age and cause of death in patients with diabetes, malignant neoplasms were the most frequent cause of death in all age groups, and the incidence was around 50% for those in their 50s and 60s. The incidence of death due to infectious diseases was highest in patients older than their 70s. The incidence of death due to vascular diseases for patients in their 40s and 50s was higher than that due to infectious diseases. The highest incidence of death due to ischemic heart diseases was observed for patients in their 40s, and that due to renal failure and heart failure in patients older than their 70s. 4. Compared to patients without diabetes, patients with diabetes demonstrated a higher incidence of death due to pancreas cancer, infectious diseases, renal failure, ischemic heart diseases and heart failure and lower incidence of death due to cerebrovascular diseases in all age groups. 5. The average age at death of patients with diabetes was 74.4 years old in men and 77.4 years old in women, which were lower than the average lifespan of the Japanese general population in 2020 by 7.2 and 10.3 years, respectively. However, these differences were smaller than in previous surveys. 6. The average age at death due to all causes, especially due to ischemic heart diseases, cerebrovascular diseases, heart failure, infectious diseases, and diabetic coma, was lower in patients with "poorer" glycemic control than in those with "better" glycemic control. 7. In the total survey population, the average age at death of patients with diabetes was significantly higher than that of patients without diabetes. The average age at death due to malignant neoplasms and cerebrovascular diseases was higher in patients with diabetes than in those without diabetes and that due to renal failure, ischemic heart diseases, and infectious diseases was lower in patients with diabetes than in those without diabetes.

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基于 2011-2020 年间 68,555 个病例调查结果的日本糖尿病患者死亡原因:糖尿病死亡原因委员会报告,日本糖尿病学会(英文版)。
根据对医院记录的调查,确定了 2011 年至 2020 年期间在日本 208 家医院死亡的 68,555 名糖尿病患者和 164,621 名非糖尿病患者的主要死因。1.糖尿病患者最常见的死因是恶性肿瘤(38.9%)(肺部 7.8%、胰腺 6.5%、肝脏 4.1%),其次依次是传染病(17.0%)和血管疾病(10.9%)(脑血管疾病 5.2%、缺血性心脏病 3.5%、肾功能衰竭 2.3%)。恶性肿瘤和血管疾病的死亡比例分别呈上升和下降趋势。几乎所有死于缺血性心脏病的病例都是由于心肌梗死,而死于缺血性心脏病以外的心脏病的比例相对较高(9.0%),其中大多数病例是由于心力衰竭。与高血糖相关的糖尿病昏迷仅占死亡人数的 0.3%。2.2. 糖尿病患者死于恶性肿瘤、传染病、肾功能衰竭、缺血性心脏病和心力衰竭的比例明显高于非糖尿病患者,而糖尿病患者死于脑血管疾病的比例明显低于非糖尿病患者。3.3. 关于糖尿病患者年龄与死因之间的关系,恶性肿瘤是所有年龄组中最常见的死因,50 至 60 岁年龄组的发病率约为 50%。在 70 岁以上的患者中,传染病致死率最高。四五十岁患者因血管疾病死亡的发生率高于因传染病死亡的发生率。40 多岁患者因缺血性心脏病死亡的比例最高,70 多岁患者因肾功能衰竭和心力衰竭死亡的比例最高。4.与非糖尿病患者相比,在所有年龄组中,糖尿病患者因胰腺癌、感染性疾病、肾功能衰竭、缺血性心脏病和心力衰竭死亡的发生率较高,而因脑血管疾病死亡的发生率较低。5.5. 糖尿病患者的平均死亡年龄男性为 74.4 岁,女性为 77.4 岁,分别比 2020 年日本普通人口的平均寿命低 7.2 岁和 10.3 岁。不过,这些差异比以往的调查要小。6.血糖控制 "较差 "的患者死于各种原因的平均年龄低于血糖控制 "较好 "的患者,尤其是缺血性心脏病、脑血管疾病、心力衰竭、感染性疾病和糖尿病昏迷。7.在所有调查人群中,糖尿病患者的平均死亡年龄明显高于非糖尿病患者。糖尿病患者因恶性肿瘤和脑血管疾病死亡的平均年龄高于非糖尿病患者,而糖尿病患者因肾功能衰竭、缺血性心脏病和感染性疾病死亡的平均年龄低于非糖尿病患者。
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来源期刊
Diabetology International
Diabetology International ENDOCRINOLOGY & METABOLISM-
CiteScore
3.90
自引率
4.50%
发文量
42
期刊介绍: Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.
期刊最新文献
General aspects of genetic studies on diabetes mellitus. Causes of death in Japanese patients with diabetes based on the results of survey of 68,555 cases during 2011-2020: committee report on causes of death in diabetes mellitus, Japan Diabetes Society (English version). Prognostic factors for hospitalization for severe hypoglycemia without diabetes mellitus: a retrospective study. Two cases of conventional fulminant type 1 diabetes: following the depletion process of endogenous insulin secretion and literature review. Calculated estimation of the metabolic clearance rate of insulin measured by glucose clamp examination in out-patient clinical practice.
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