ArticleBMJ open diabetes research & care2023
Variations in all-cause mortality, premature mortality and cause-specific mortality among persons with diabetes in Ontario, Canada.
Article in BMJ open diabetes research & care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- A systematic review and meta-analysis of the association between low socioeconomic status and all-cause mortality in patients with diabetes.Frontiers in public health · 2026Pooled it
- Palliative Care With Tracheostomy or Gastrostomy Tube Use and End-of-Life Quality and Costs Among Patients With Head and Neck Cancer.JAMA otolaryngology-- head & neck surgery · 2025Article
- Additive effect of diabetes mellitus on the prevalence and prognosis of sarcopenic obesity: Implications for all-cause mortality.PloS one · 2025Article
- Association of environmental enteropathy with prediabetes and diabetes: A cross-sectional study among Tanzanian adults.PloS one · 2025Article
- Global spatiotemporal trends and influencing factors of type 2 diabetes mellitus mortality: estimates and predictions from 1990 to 2040.Frontiers in endocrinology · 2025Article
- Validity of the Leading Causes of Death Classification for Premature Mortality in Inflammatory Bowel Disease: A Population-Based Comparison with ICD-10 Coding in Ontario, Canada.Clinical epidemiology · 2025Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
introductionPatients with diabetes have a higher risk of mortality compared with the general population. Large population-based studies that quantify variations in mortality risk for patients with diabetes among subgroups in the population are lacking. This study aimed to examine the sociodemographic differences in the risk of all-cause mortality, premature mortality, and cause-specific mortality in persons diagnosed with diabetes. RESEARCH DESIGN AND
methodsWe conducted a population-based cohort study of 1 741 098 adults diagnosed with diabetes between 1994 and 2017 in Ontario, Canada using linked population files, Canadian census, health administrative and death registry databases. We analyzed the association between sociodemographics and other covariates on all-cause mortality and premature mortality using Cox proportional hazards models. A competing risk analysis using Fine-Gray subdistribution hazards models was used to analyze cardiovascular and circular mortality, cancer mortality, respiratory mortality, and mortality from external causes of injury and poisoning.
resultsAfter full adjustment, individuals with diabetes who lived in the lowest income neighborhoods had a 26% (HR 1.26, 95% CI 1.25 to 1.27) increased hazard of all-cause mortality and 44% (HR 1.44, 95% CI 1.42 to 1.46) increased risk of premature mortality, compared with individuals with diabetes living in the highest income neighborhoods. In fully adjusted models, immigrants with diabetes had reduced risk of all-cause mortality (HR 0.46, 95% CI 0.46 to 0.47) and premature mortality (HR 0.40, 95% CI 0.40 to 0.41), compared with long-term residents with diabetes. Similar HRs associated with income and immigrant status were observed for cause-specific mortality, except for cancer mortality, where we observed attenuation in the income gradient among persons with diabetes.
conclusionsThe observed mortality variations suggest a need to address inequality gaps in diabetes care for persons with diabetes living in the lowest income areas.
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