title: Diabetes mortality in Serbia, 1991-2015 (a nationwide study): A joinpoint regression analysis.
abstract: The aim of this study was to analyze the mortality trends of diabetes mellitus in Serbia (excluding the Autonomous Province of Kosovo and Metohia).
  
  
  
  A population-based cross sectional study analyzing diabetes mortality in Serbia in the period 1991-2015 was carried out based on official data. The age-standardized mortality rates (per 100,000) were calculated by direct standardization, using the European Standard Population. Average annual percentage of change (AAPC) and the corresponding 95% confidence interval (CI) were computed using the joinpoint regression analysis.
  
  
  
  More than 63,000 (about 27,000 of men and 36,000 of women) diabetes deaths occurred in Serbia from 1991 to 2015. Death rates from diabetes were almost equal in men and in women (about 24.0 per 100,000) and places Serbia among the countries with the highest diabetes mortality rates in Europe. Since 1991, mortality from diabetes in men significantly increased by +1.2% per year (95% CI 0.7-1.7), but non-significantly increased in women by +0.2% per year (95% CI -0.4 to 0.7). Increased trends in diabetes type 1 mortality rates were significant in both genders in Serbia. Trends in mortality for diabetes type 2 showed a significant decrease in both genders since 2010.
  
  
  
  Given that diabetes mortality trends showed different patterns during the studied period, our results imply that further observation of trend is needed.
authors.affiliation: Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia. Electronic address: drmilenailic@yahoo.com.
authors.forename: Milena
authors.initials: M
authors.lastname: Ilic
authors.affiliation: Faculty of Medical Sciences, University of Kragujevac, Serbia.
authors.forename: Irena
authors.initials: I
authors.lastname: Ilic
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000401:mortality*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D055771:Serbia / Q000453:epidemiology; D017678:Sex Distribution; D013997:Time Factors
keywords: Diabetes; Joinpoint regression analysis; Mortality; Trend