Diabetes and its complications are major causes of illness, disability and death in Australia. People with diabetes are more likely to die prematurely than people without diabetes. This report examines the 156,000 deaths that occurred between 2009 and 2014 among 1.3 million Australians with diagnosed type 1 and type 2 diabetes. Specifically, data from the National Diabetes Services Scheme and the National Death Index were combined to look at causes of death and death rates for people with diabetes compared with the general population. Creating a comprehensive picture of diabetes-related deaths is important for population-based prevention strategies and could help to improve care for all people with diabetes.
Death rates for people with diabetes almost double that of other Australians
Compared with the Australian population, death rates for people with diabetes were nearly twice as high for those with type 1 diabetes in 2012–2014, and 1.6 times as high for those with type 2 diabetes in 2014. This higher mortality was apparent across sex, age, socioeconomic status and remoteness (for type 2 diabetes only) groups. The disparity in death rates between people with diabetes and the general population was highest at younger ages—death rates were 4.5 times as high for people aged under 45 with type 1 diabetes and almost 6 times as high for those with type 2 diabetes, compared with the Australian population of the same age.
Death rates fell for people with type 1 diabetes but rose for those with type 2 diabetes
Between 2009 and 2014, death rates fell by 20% for people with type 1 diabetes but rose by 10% for those with type 2 diabetes. Death rates also fell in the general population over this period but not as steeply as among people with type 1 diabetes. This means that compared with the general population, the mortality gap widened for people with type 2 diabetes but reduced for those with type 1 diabetes.
Death rates increased with increasing socioeconomic disadvantage and remoteness
People with diabetes living in the lowest socioeconomic areas experienced higher death rates than those in the highest socioeconomic areas. Among people with type 2 diabetes, the highest death rates were in Remote and very remote areas.
Leading causes of death
Diabetes, coronary heart disease and cerebrovascular disease were the most common underlying causes of death among people with type 1 or type 2 diabetes. Kidney failure was also a leading cause of death for people with type 1 diabetes, while dementia (including Alzheimer disease) was also a leading cause of death among those with type 2 diabetes.
Cardiovascular disease death rates fell for people with type 1 diabetes but remain high
Between 2009 and 2014, at the disease group level, cardiovascular disease (CVD) was the second most common underlying cause of death among people with type 1 diabetes and the most common among those with type 2 diabetes. Over this period, CVD death rates among people with type 1 diabetes fell more sharply than in the general population but there was little change in rates among people with type 2 diabetes. This means that the mortality gap reduced for those with type 1 diabetes but widened for those with type 2 diabetes.