Comparison of mortality data should be interpreted with caution

Based on data on causes of death obtained from death certificates, about 103,000 persons have died from diabetes mellitus in the EU-27 in 2004 (Eurostat, 2007). Although more women than men died from diabetes (61,000 women and 44,000 men) standardised death rates (SDR) are higher for men (see Mortality from diabetes in 2003). Data based on registered primary causes of death seriously underestimate the actual number of deaths for which diabetes was a contributing factor (Roglic et al., 2005). As many diabetes patients die of cardiovascular disease, it is usually the cardiovascular disease that is recorded as the primary cause of death. Furthermore, methods of registration differ between countries and this affects the comparability of data. Therefore, the mortality data for diabetes and their international comparisons should be interpreted with some caution.

Changes in registration can influence mortality trends

There is no clear trend in the standardised death rates (SDR) for diabetes in EU countries since 1970 (WHO-HFA, 2006). A few countries showed some increase since 1980 (Portugal, Denmark). Austria showed a remarkable increase since 2000. On the other hand Belgium, Finland, Greece and the Czech Republic report some decrease since 1970. We mentioned already, however, that mortality data should be interpreted with caution. Changes in registration or attention for diabetes as primary cause of death could influence trends.