Diabetes mortality burden attributable to influenza in China: A population-based time-series analysis.

BACKGROUND

Previous studies have found an association between influenza, cardiovascular and cerebrovascular disease mortality, and all-cause mortality. And the vaccination of elderly diabetes is often recommended to reduce the risk of hospitalization and death. Nevertheless, no previous work has investigated the short-term impact of influenza on diabetes mortality in China. In this study, data from the national surveillance system was used to quantify the impact of influenza on diabetes-related mortality and provide guidance for the care of diabetes patients.

METHODS

Data from the National Influenza Surveillance Center was collected for the period between 2015 and 2019 and weekly diabetes-related deaths were calculated from China's Disease Surveillance Points System (CDSP). A distributed non-linear lag model (DLNM) was used to 1] analyze the delayed impact of high influenza virus-positive rates on diabetes-related mortality, 2] calculate the relative risk of diabetes deaths caused by high influenza virus-positive rate, and 3] estimate the attributable risk of diabetes deaths caused by influenza in China.

RESULTS

A total of 260 weeks of influenza weekly data from southern and northern China were included in this study. This resulted in 256,845 diabetes-related deaths with an average age of 73.36 years. During this period, the mean influenza virus-positive rate was 12.79 %. The relative risk of death from diabetes at high influenza positive rate was 1.33 (95 % CI [1.25, 1.40]) in southern China and 1.14 (95 % CI [1.08, 1.20]) in northern China for a 3-week lag. The estimated population attributable fraction (PAF) was 9.64 % (95 % CI [6.6 %, 12.55 %]) in southern China and 1.69 % (95 % CI [-0.04 %, 3.35 %]) in northern China. The present study suggest that reducing the influenza virus-positive rate to optimal levels could potentially prevent approximately 10,871 diabetes-related deaths annually.

CONCLUSION

A high influenza virus-positive rate is associated with an increased risk of diabetes-related mortality. Moreover, this effect is consistent across geographical areas and gender groups. Overall, the present study suggests that the risk of diabetes-related mortality attributable to influenza is high in China.