Diabetes and all-cause mortality among middle-aged and older adults in China, England, Mexico, rural South Africa, and the USA: a population-based study of longitudinal aging cohorts
Authors' conclusion
Diabetes was associated with increased all-cause mortality in population-based cohorts in China, England, Mexico, rural South Africa, and the USA. Limitations included differences in diabetes biomarkers and selection criteria across cohorts. The results highlight the urgent need to implement clinical and public health interventions worldwide to reduce excess diabetes mortality.
Study context
- Population
- Adults aged 51 years or older followed 2010–2020 in population-based cohorts from China, England, Mexico, rural South Africa and the USA4,916 (16.7%) died
- Participants
- 29,397 adults
- Exposure
- Diabetes vs no diabetes
- Outcome
- All-cause mortality (adjusted mortality rate ratios and rate differences)
- Follow-up
- Median 4.6 years (South Africa) to 8.3 years (China)
Methodological detailslongitudinal aging cohorts, multinational (China, England, Mexico, rural South Africa, USA), Poisson regression adjusted for age, gender, education, smoking status, BMI, economic status and, in South Africa, HIV status
- Longitudinal aging cohorts
- Multinational (China, England, Mexico, rural South Africa, USA)
- Poisson regression adjusted for age, gender, education, smoking status, BMI, economic status and, in South Africa, HIV status
Main finding
As reported in the abstract
All-cause mortality
Diabetes vs No diabetesEstimate (95% CI)
USA
adjusted mortality rate ratio, lowest (USA) 1.53(1.39–1.68)
Mexico
adjusted mortality rate ratio, highest (Mexico) 2.02(1.34–3.06)
Diabetes vs No diabetesEstimate (95% CI)
England
adjusted mortality rate difference, lowest (England) 11.9 per 1000 person-years(4.8–18.9)
South Africa
adjusted mortality rate difference, highest (South Africa) 24.6 per 1000 person-years(12.2–37.0)
Observational data: associations, not effects.
Original publication
Diabetes and all-cause mortality among middle-aged and older adults in China, England, Mexico, rural South Africa, and the USA: a population-based study of longitudinal aging cohorts. BMJ Open Diabetes Res Care. Published 18 March 2025. doi:10.
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