title: Geography of diabetes mellitus mortality in Mexico: an epidemiologic transition analysis.
abstract: BACKGROUND
  The worldwide prevalence of diabetes mellitus (DM) will increase from 135 to 300 million cases by the year 2025. In Mexico, DM is the third cause of general mortality and the primary cause of mortality in the 55- to 64-year-old age group. The purpose of this study was to analyze the characteristics of DM mortality trends in Mexico from 1980 to 2000 in the context of this epidemiologic transition.
  
  
  METHODS
  Age-adjusted mortality rates were estimated for DM as underlying cause of death using World Health Organization (WHO) reference population. To evaluate magnitude of risks, standardized mortality ratio (SMR) was calculated; prematurity of mortality was evaluated by means of potential lost life years index (PLLYI). Diabetes mortality trends in the U.S. were calculated with information from the Centers for Disease Control (CDC) public registry and were age-adjusted for comparison.
  
  
  RESULTS
  Total number of deaths due to DM during the period was 582,826. Standardized mortality ratio by state showed higher mortality in the northern Mexican states; PLLYI was higher in the northern states. Mortality trends in Mexico showed a rapid increase during the 1980s followed by a less acute increment in the 1990s. Age-adjusted mortality rate trends in the U.S. were lower than those in Mexico.
  
  
  CONCLUSIONS
  This study shows an increase in DM age-adjusted mortality trends during the years 1980-2000 in Mexico. The observed pattern of mortality varies widely throughout the country, probably due to differences in socioeconomic conditions and in access to healthcare.
authors: Departamento de Enfermedades Crónicas y Dieta, División de Enfermedades Crónicas, Instituto Mexicano de Salud Pública (INSP), Cuernavaca, Morelos, Mexico. sbarquera@insp.mx
authors: Simón
authors: S
authors: Barquera
authors: Víctor
authors: V
authors: Tovar-Guzmán
authors: Ismael
authors: I
authors: Campos-Nonato
authors: Clicerio
authors: C
authors: González-Villalpando
authors: Juan
authors: J
authors: Rivera-Dommarco
mesh_terms: D002423:Cause of Death / Q000639:trends*; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors