Faculdade de Odontologia de Bauru Universidade de São Paulo BauruSP Brasil Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brasil.
Arch Endocrinol Metab. 2024 Jun 24;68:e230443. doi: 10.20945/2359-4292-2023-0443. eCollection 2024.
To evaluate, characterize and search for trends in the underreporting of diabetes mellitus (DM) as the cause of death in Bauru, São Paulo, Brazil, over 40 years.
This was a documental study. Clinical and mortality data were collected from individuals known to have type 1 (DM1) and type 2 diabetes mellitus (DM2), residing in Bauru, State of São Paulo, followed at a local endocrinology clinic from 1982 to 2021, who deceased during this period.
A significant underreporting of DM as the cause of death (64.41%) was found, mostly associated with male gender (OR = 1.59 [95% CI: 1.18; 2.15]; p < 0.01), DM2 (OR = 2.64 [95% CI: 1.32; 5.26]; p < 0.01), dying in the first decade of the study (OR = 4.07 [95% CI: 1.54; 10.71]; p < 0.001) and shorter DM duration (OR = 1.02 [95% CI: 1.01; 1.04]; p < 0.01). Age, type of treatment, body mass index, marital status and ethnicity, did not show a significant association with DM underreporting. There was a decreasing trend in DM1 underreporting (Decade Percentual Change = -7.10 [95% CI: -11.35; -3.40]), but a stationary trend for DM and DM2. The main primary cause of death was cardiovascular-related complications.
The underreporting of DM as the cause of death was very frequently found, and was associated with male gender, decade of death, shorter DM duration and DM2. If our data could be applied to the whole country, DM would possibly emerge as a more prominent cause of death in Brazil. Future studies in other cities and geographic regions are warranted to confirm our findings.
评估、描述并寻找巴西保利斯塔州包鲁市 40 多年来糖尿病（DM）作为死因漏报的趋势。
这是一项文献研究。从 1982 年至 2021 年期间在当地内分泌科诊所就诊的 1 型（DM1）和 2 型糖尿病（DM2）患者中收集了居住在保利斯塔州包鲁市、已知患有糖尿病并在此期间死亡的患者的临床和死亡数据。
发现 DM 作为死因的漏报率很高（64.41%），主要与男性（OR = 1.59 [95% CI：1.18；2.15]；p < 0.01）、DM2（OR = 2.64 [95% CI：1.32；5.26]；p < 0.01）、研究早期死亡（OR = 4.07 [95% CI：1.54；10.71]；p < 0.001）和较短的 DM 病程（OR = 1.02 [95% CI：1.01；1.04]；p < 0.01）有关。年龄、治疗类型、体重指数、婚姻状况和种族与 DM 漏报无显著相关性。DM1 漏报率呈下降趋势（十年百分比变化=-7.10 [95% CI：-11.35；-3.40]），而 DM 和 DM2 则呈稳定趋势。主要的初级死因是心血管相关并发症。
DM 作为死因的漏报非常常见，与男性、死亡年代、较短的 DM 病程和 DM2 有关。如果我们的数据可以应用于整个国家，DM 可能会成为巴西更突出的死因。需要在其他城市和地理区域进行进一步研究以证实我们的发现。
