Population-based estimates of mortality associated with diabetes: Use of adeath certificate check box in North Dakota

Objectives. Overall and cause-specific mortality among persons with diabete s in Noah Dakota was estimated and compared with estimates from previous po pulation-based studies. Methods. Data were derived from North Dakota death certificate data, which included unique information on decedents' diabetes status and Behavioral Ri sk Factor Surveillance System estimates of the diabetic and nondiabetic adu lt populations of North Dakota. Results. The risk of death among adults with diabetes was 2.6 (2.2, 2.9) ti mes that of adults without diabetes. Relative risks of death among adults w ith diabetes were at least twice as high for heart disease, cerebrovascular disease, accidents and adverse events, and kidney disease and 70% to 80% h igher for pneumonia and influenza, malignant neoplasms, arterial disease, a nd other causes. Risks remained substantial in the oldest age group. These findings are comparable to results of other population-based studies. Conclusions. Diabetes status information enhanced the usefulness of death c ertificate data in examining mortality associated with diabetes and confirm s that the effect of diabetes on death is substantial.