Trends in Mortality From Diabetes Mellitus in Spain: 1998-2013.
OBJECTIVE
Diabetes mellitus (DM) is a leading causes of death, mainly due to cardiovascular complications. The aim of this study was to describe DM mortality in Spain from 1998 to 2013 and to compare it between distinct provinces.


METHODS
Ecological time-trend study. Data sources consisted of the population register and the death rate figures, by cause of death, from Spain's National Statistics Institute. Rates were age-standardized by the direct method. Standardized mortality rates were calculated for each province every 5 years (1998-2013). Time trends in mortality were established by joint point regression models.


RESULTS
The standardized mortality rate for DM fell markedly, by 25.3% in men and by 41.4% in women from 1998 to 2013. At the beginning of the study period, mortality rates were higher in southern than in northern regions, but this difference gradually disappeared in later years. The highest mortality rates were consistently found in the Canary Islands.


CONCLUSIONS
Mortality from DM fell substantially from 1998 to 2013. The marked geographical clustering showing higher mortality in the south and southeastern areas of the country was significantly reduced during the study period, except in the Canary Islands, where mortality remains strikingly high.
Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, Alicante, Spain. Electronic address: dorozco@goumh.umh.es.
Domingo
D
Orozco-Beltrán
Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, Alicante, Spain.
Eva
E
Sánchez
Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, Alicante, Spain.
Alejandro
A
Garrido
Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, Alicante, Spain.
José Antonio
JA
Quesada
Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, Alicante, Spain.
M Concepción
MC
Carratalá-Munuera
Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, Alicante, Spain.
Vicente F
VF
Gil-Guillén
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends
Atención primaria; Diabetes mellitus; Epidemiology; Epidemiología; Mortalidad; Mortality; Población; Population; Primary care