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Burden of disease from diabetes

ENLACE BURDEN OF DIABETES RAISED BLOOD GLUCOSE TECHNICAL NOTES ABOUT

 

Diabetes mellitus is a metabolic disease characterized by elevated levels of blood glucose. Its main types are type 1 diabetes, type 2 diabetes (the most frequent), and gestational diabetes. Diabetes is a leading cause of mortality and disability in countries of the Americas. It is the second leading cause of DALYs in the Region, and estimates indicate that the burden will continue increasing in the following years. The Pan American Health Organization, through the Global Diabetes Compact initiative, is providing technical cooperation to countries of the Region to prevent and control the diabetes burden.

This visualization presents the level and trends of mortality and burden of diabetes (excluding chronic kidney disease due to diabetes) by age, sex, and location (country, subregion, and Region) in the Americas from 2000 to 2019.

Mortality

In 2019, regionwide diabetes mellitus (excluding kidney diseases due to diabetes) accounts for:

  • 284,049 deaths, 139,651  deaths in men, and 144,398 deaths in women.
  • The age-standardized death rate due to diabetes was estimated at 20.9 deaths per 100,000 population.
  • Age-standardized deaths rates from diabetes vary across countries from a high in Guyana (82.6 deaths per 100,000 population) to a low in Canada (7.2 deaths per 100,000 population).

The countries with the highest age-standardized death rates due to diabetes are: 

  • Guyana
  • Mexico
  • Trinidad and Tobago
  • Haiti
  • Grenada
  • Guatemala
  • Jamaica

Years of life lost due to premature mortality

In 2019, diabetes mellitus account for:

  • 6.2 million years of life lost, equivalent to 618 YLLs per 100,000 population.
  • The absolute number of YLL increased from 4.0 million years in 2000 to 6.2 million years in 2019.
  • The crude YLL rate increased from 438 years per 100,000 population in 2000 to 618 years per 100,000 population in 2019.
  • The age-standardized YLL rates remained constant from 2000 to 2019.

The countries with the highest YLL rates due to diabetes are:

  • Guyana
  • Haiti
  • Mexico
  • Guatemala
  • Trinidad and Tobago
  • Grenada
  • Saint Lucia

Years lived with disability

In 2019, regionwide, diabetes mellitus account for:

  • 7.2 million years of life lived with disability, equivalent to 711.8 YLDs per 100,000 population.
  • The crude YLD rate almost doubled in 2019 relative to its level in 2000 (376.0 years per 100,000 population).
  • Age-standardized YLD rates increased from 404.2 yaars per 100,000 population in 2000 to 582.2 years per 100,000 population in 2019.

The countries with the highest levels of years of life lived with disability from diabetes are:

  • Saint Lucia
  • Trinidad and Tobago
  • Guyana
  • Suriname
  • Saint Vincent and the Grenadines
  • Grenada
  • Mexico
Suggested citation

PAHO. The burden of Diabetes mellitus in the Region of the Americas, 2000-2019. Pan American Health Organization. 2021.

DATA CLASSIFICATION

In the map and bar chart, the data is presented in five discrete classes created using the quantile classification method. Each class contains 20% of countries, which is easy to interpret. The quintile classes are labeled sequentially from Quintile 1 as the first quintile including the lowest fifth (0 to 20%) of the data to Quintile 5, the fifth quintile representing the class with the highest fifth (80% to 100%) of the data.

MEASURES

Measure names: Deaths, Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLDs), and Years of Life Lost (YLLs) due to diabetes mellitus.

Metric: Rate. 

Unit of Measure: deaths, DALY, YLD, and YLL per 100,000 population.

Topic: Mortality and burden of disease.

Rationale: Measuring how many people die each year and why they died is one of the most important means – along with gauging how diseases and injuries are affecting people's health – for assessing the effectiveness of a country’s health system. Statistics of causes of death help health authorities evaluate and focalize public health actions.

Disaggregation: Age, Sex, Country, and Year.

Method of estimation: Mortality estimates by cause, age, sex, location (countries, and the region), and year were extracted from the WHO Global Health Estimates (GHE) 2000-2019. These estimates represent WHO's best estimates, computed using standard categories, definitions, and methods to ensure cross-country comparability, and may not be the same as official national estimates. 

Methodological details:

Data sources and methods for estimating causes of deaths and burden of diseases are described in the following documents:

Method of estimation of global and regional aggregates: Global, regional and subregional aggregates were computed by summing the absolute number of the measure (deaths, DALYs, YLDs, YLL) as the numerator and summing the population estimates from the World Population Prospect, produced by the UN Population Division, as denominators for all countries included in the geographic region or subregion. Rates were computed by dividing the aggregated numerator and aggregated population and multiplying the result y 100,000 population. Age-standardized rates were computed by the direct method using the World Standard Population. 

Preferred data sources: Civil registration and vital statistics (CRVS) system with complete coverage and medical certification of cause of death.

Effective approaches are available to prevent type 2 diabetes and to prevent the complications and premature death that can result from all types of diabetes. These include policies and practices across whole populations and within specific settings (school, home, workplace) that contribute to good health for everyone, regardless of whether they have diabetes, such as exercising regularly, eating healthily, avoiding smoking, and controlling blood pressure and lipids. 

Early diagnosis is a key starting point for living well with diabetes – the longer a person lives with undiagnosed and untreated diabetes, the worse their health outcomes are likely to be. Easy access to basic diagnostics, such as blood glucose testing, should therefore be available in primary health care settings. Patients will need periodic specialist assessments or treatment for complications. 

A series of cost-effective interventions can improve patient outcomes, regardless of what type of diabetes they may have. These interventions include:

  • blood glucose control, through a combination of diet, physical activity and, if necessary, medication;
  • control of blood pressure and lipids to reduce cardiovascular risk and other complications; and
  • regular screening for damage to the eyes, kidneys and feet, to facilitate early treatment. 
  1. WHO. WHO methods and data sources for country-level causes of death 2000-2019. Geneva: World Health Organization; 2020. Available online (accessed 1 February 2021).
  2. WHO. WHO methods and data sources for global burden of disease estimates, 2000-2019. Geneva: World Health Organization, 2020. Available online (accessed 1 February 2021).
  3. PAHO. Methodological Notes, NMH Data Portal. Pan American Health Organization. 2021.
  4. WHO. Topic on Diabetes Mellitus. World Health Organization. Available online (accessed 17 June 2021).

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