Pritchard Colin, Peveler Robert
Institute of Health & Community Studies, Bournemouth University, Bournemouth House, 17-19 Christchurch Rd, Bournemouth BH 13 LH, UK.
Int J Adolesc Med Health. 2003 Apr-Jun;15(2):169-77. doi: 10.1515/ijamh.2003.15.2.169.
The objective was to examine any changes in "Diabetic Deaths" in major developed countries 1974-97 and to determine whether youth (aged 15-24 years) and young adult (aged 25-44 years) males are at greater risk of Diabetic Death (DD) than women by comparing DD with "All Cause Deaths" (ACD) by gender.
Based upon WHO standardized mortality data, three year average death rates for 1974-76 were contrasted against three year average for 1995-97 for ACD and DD rate per million, by gender. Ratios of change for each country were calculated, which were then used for comparison between countries, thus ensuring comparison of like with like, resolving the inherent problem of differential recording between countries. Ratios of ratios were calculated between the ACD and DD ratios by gender indicating any changes between mortalities by gender over the period. Chi square tests examined differences between the gender.
ALL CAUSE DEATHS: Wide range of male ACD, lowest Japan 939 (per million p.m) to USA 2039 p.m. but there were substantial falls (< 0.2) in five countries. Female ACD ranged from Japan 485 p.m. to USA 889 but fell substantially in every country except the Netherlands. DIABETIC DEATHS: Male DD highest in USA at 24 p.m., lowest Italy 6 p.m. with substantial falls in 8 countries. Female DD were 17 p.m. in USA and 3 p.m. in France and Spain. Fell substantially in every country except the USA. DD:ACD male rates saw substantial improvements in Ratio of Ratios (RoR) in France, Italy and Spain but rose 1.22 in USA. Female RoR showed better improvements in DD in France, Netherlands and Spain but substantial rises in Canada and USA. DD AND GENDER: In every country there were more male than female DD and over time male DD worsened significantly compared to female DD in Japan, Netherlands, Spain and USA.
Whilst diabetes continues to be associated with greater mortality, over the period there have been major improvements in DD relative to ACD deaths, especially amongst females. Nonetheless, there are still gains to be made if compliance can be further improved amongst male patients.
目的是研究1974年至1997年主要发达国家“糖尿病死亡”情况的变化，并通过按性别比较糖尿病死亡（DD）与“全因死亡”（ACD），确定15至24岁的青年男性和25至44岁的年轻成年男性是否比女性面临更高的糖尿病死亡风险。
基于世界卫生组织的标准化死亡率数据，按性别对比了1974 - 1976年的三年平均死亡率与1995 - 1997年每百万人口的ACD和DD三年平均死亡率。计算了每个国家的变化率，然后用于国家间比较，从而确保同类比较，解决国家间记录差异的固有问题。计算了按性别划分的ACD和DD比率之间的比率比，表明该时期按性别划分的死亡率之间的任何变化。卡方检验考察了性别差异。
全因死亡：男性ACD范围广泛，日本最低为每百万人口每年939例，美国为每百万人口每年2039例，但五个国家有大幅下降（<0.2）。女性ACD从日本的每百万人口每年485例到美国的889例不等，但除荷兰外每个国家都大幅下降。糖尿病死亡：男性DD在美国最高，为每百万人口每年24例，意大利最低为每百万人口每年6例，8个国家有大幅下降。女性DD在美国为每百万人口每年17例，在法国和西班牙为每百万人口每年3例。除美国外每个国家都大幅下降。DD:ACD男性比率在法国、意大利和西班牙的比率比（RoR）有显著改善，但在美国上升了1.22。女性RoR在法国、荷兰和西班牙的DD方面显示出更好的改善，但在加拿大和美国大幅上升。糖尿病死亡与性别：每个国家男性糖尿病死亡人数都多于女性，随着时间推移，在日本、荷兰、西班牙和美国，与女性糖尿病死亡相比，男性糖尿病死亡显著恶化。
虽然糖尿病仍然与更高的死亡率相关，但在此期间，相对于ACD死亡，糖尿病死亡有了重大改善，尤其是在女性中。尽管如此，如果男性患者的依从性能够进一步提高，仍有进步空间。
