title: Trends in mortality due to diabetes in Brazil, 1996-2011.
abstract: BACKGROUND
  Over recent decades, Brazilian mortality registration has undergone increasing improvement in terms of completeness and quality in cause of death reporting. These improvements, however, complicate the description of mortality trends over this period. We aim to characterize the trend in diabetes mortality in Brazil and its five regions in adults (30-69 years), from 1996 to 2011 after corrections for underreporting of deaths and redistribution of ill-defined causes and "garbage codes".
  
  
  METHODS
  Starting with official data from the Brazilian Mortality Information System (SIM) for adults aged 30-69 in the period 1996 to 2011 for diabetes (ICD-10 codes E10-14), we redistributed garbage codes using methods based on the Global Burden of Disease Study (2010), redistributed ill-defined causes based on recent Brazilian investigations of similar cases and corrected for underreporting using official estimates of deaths.
  
  
  RESULTS
  With these corrections, age-standardized mortality fell approximately 1.1 %/year for men and 2.2 %/year for women from 1996 to 2011. The rate of decline first accelerated and then decelerated, reaching stable rates in men and minimal declines in women from 2005 onward. Regional inequalities decreased during the period in both relative and absolute terms.
  
  
  CONCLUSIONS
  Mortality due to diabetes declined in Brazil from 1996 to 2011, minimally in men and considerably in women. The lesser declines in recent years may reflect the increasing prevalence of diabetes, and suggest that current efforts to prevent diabetes and minimize the impact of its complications need to be reinforced to ensure that declines will continue.
authors.affiliation: Postgraduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600/414, Porto Alegre, RS 90035-003 Brazil.
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Schmidt
authors.affiliation: Postgraduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600/414, Porto Alegre, RS 90035-003 Brazil.
authors.forename: Bruce B
authors.initials: BB
authors.lastname: Duncan
authors.affiliation: Secretaria Municipal de Saúde de Belo Horizonte, Belo Horizonte, MG Brazil.
authors.forename: Lenice
authors.initials: L
authors.lastname: Ishitani
authors.affiliation: Statistics Department, Federal University of Minas Gerais, Belo Horizonte, MG Brazil.
authors.forename: Glaura
authors.initials: G
authors.lastname: da Conceição Franco
authors.affiliation: Grupo de Pesquisa em Epidemiologia e Avaliação em Saúde-(GPEAS), Federal University of Minas Gerais, Belo Horizonte, MG Brazil.
authors.forename: Daisy Maria Xavier
authors.initials: DM
authors.lastname: de Abreu
authors.affiliation: Statistics Department, Federal University of Minas Gerais, Belo Horizonte, MG Brazil.
authors.forename: Gustavo C
authors.initials: GC
authors.lastname: Lana
authors.affiliation: Postgraduate Program in Public Health, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG Brazil.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: França