Diabetes-related death

The term 'diabetes-related death' is used in HealthStats NSW to refer to deaths where diabetes was recorded as the underlying cause of death, or where diabetes was recorded as an associated cause of death and the underlying cause of death was one of the commonly recognised diabetes complications. An underlying cause of death is often called a 'principal' cause and an associated cause 'contributing'. The common complications of diabetes included in the definition of diabetes-related deaths are: myocardial infarction, ischaemic heart disease, stroke or sequelae of stroke, heart failure, sudden death (cardiac arrest), peripheral vascular disease, kidney disease, hyperglycaemia and hypoglycaemia (Dixon et al. 2005).

The reason for defining diabetes deaths in this way is that, more than other disorders, diabetes often causes death indirectly as it is an important risk factor for common causes of death such as heart, kidney disease and stroke. These diseases are likely to appear as the underlying cause of death which is the basis for official mortality statistics. The inclusion of deaths from diabetes as the underlying cause only would lead to a considerable underestimation of the overall mortality burden caused by diabetes (Dixon et al. 2005).

This concept of 'diabetes-related deaths' is based on the definition of 'death related to diabetes' used in the United Kingdom Prospective Diabetes Study (UKPDS) since 1998. The UKPDS definition has been modified by diabetes specialists of the National Diabetes Data Working Group, associated with the Australian Institute of Health and Welfare (AIHW). The Group included additional conditions in the Australian definition. These conditions are: ischaemic heart disease, stroke or sequelae of stroke and heart failure (Dixon et al. 2005).

Refer to HealthStats PLUS  methods paper Understanding diabetes mortality in NSW for further details; and the web page: Diabetes deaths code table for the full list of codes of conditions used to define 'diabetes-related' deaths.

Dixon T, Webbie K. Diabetes-related deaths 2001-2003. Canberra: 2005. Available at https://www.aihw.gov.au/getmedia/969f351e-ac88-4321-b0bb-ba1488cf013a/bulletin32-x00.pdf.aspx