Evidence map›Paper›PMID 40101978›Full record

ArticleBMJ open diabetes research & care2025

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.

David Flood, Yuan S Zhang, Emma Nichols, Chihua Li, Paola Zaninotto, Kenneth M Langa, Jinkook Lee, Jennifer Manne-Goehler

Abstract read
In one paragraph

Article in BMJ open diabetes research & care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

David FloodDepartment of Medicine, University of Michigan, Ann Arbor, Michigan, USA daflood@gmail.com.ORCID http://orcid.org/0000-0002-4372-7387
Yuan S ZhangDepartment of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA.
Emma NicholsCenter for Economic and Social Research, University of Southern California, Los Angeles, California, USA.
Chihua LiInstitute of Chinese Medical Sciences, University of Macau, Macao, Macao.
Paola ZaninottoUCL, London, UK.
Kenneth M LangaSurvey Research Center, University of Michigan Institute for Social Research, Ann Arbor, Michigan, USA.
Jinkook LeeCenter for Economic and Social Research, University of Southern California, Los Angeles, California, USA.
Jennifer Manne-GoehlerDivision of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA.

Funding

HRS Yrs29-34: Y33 SSA CoFundingU01AG009740 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Jessica Faul, KENNETH M LANGA · 1990 to 2026
$555.8M
Project-001R01AG017644 · NIA · UNIVERSITY OF LONDON INST OF NEUROLOGY · PI Andrew Steptoe · 2000 to 2026
$56.2M
Integrting Information About Aging SurveysR01AG030153 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Sara Adar, Alden L. Gross · 2007 to 2026
$41.7M
SOCIAL AND ECONOMIC PREDICTORS OF PHYSICAL AND COGNITIVE FUNCTIONP01AG041710 · NIA · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI LISA F BERKMAN, THOMAS A GAZIANO · 2013 to 2026
$37.3M
Research Education CoreP30AG024824 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Lona Mody, RAYMOND L YUNG · 2004 to 2026
$29.2M
The Mexican Health and Aging Study - IIR01AG018016 · NIA · UNIVERSITY OF TEXAS MED BR GALVESTON · PI Rebeca Wong · 1999 to 2026
$22.6M
Research BaseP30DK092926 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MARY ELLEN MICHELE HEISLER, ADESUWA B OLOMU · 2011 to 2026
$10.0M
Preventing Weight Gain and Diabetes in People with HIV in South AfricaK23DK125162 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI MANNE-GOEHLER, JENNIFER · 2020 to 2024
$986k
Implementation research for comprehensive cardiometabolic care in GuatemalaK23HL161271 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI David Clifford Flood · 2022 to 2026
$949k
A cross-national comparative study on cardiometabolic risk, education, and cognitive agingR00AG070274 · NIA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI ZHANG, YUAN S · 2023 to 2025
$721k
NHLBI NIH HHS K23 HL161271NIA NIH HHS P01 AG041710NIA NIH HHS P30 AG024824NIA NIH HHS R00 AG070274NIA NIH HHS R01 AG017644NIA NIH HHS R01 AG018016NIA NIH HHS R01 AG030153NIA NIH HHS U01 AG009740NIDDK NIH HHS K23 DK125162NIDDK NIH HHS P30 DK092926
6 · The paper itself

Abstract

objectiveThere is a need for comparable worldwide data on the impact of diabetes on mortality. This study assessed diabetes and all-cause mortality among middle-aged and older adults in five countries. RESEARCH DESIGN AND

methodsWe analyzed adults aged 51 years or older followed between 2010 and 2020 from population-based cohorts from China, England, Mexico, rural South Africa, and the USA. The cohorts are part of an international network of longitudinal aging studies with similar sampling designs, eligibility, and assessment methods. Diabetes was defined by self-report or an elevated diabetes blood-based biomarker meeting the clinical criteria for diabetes. All-cause mortality was assessed through linkages or informant interviews. We used Poisson regression models to estimate mortality rate ratios and mortality rate differences, comparing people with diabetes to those without diabetes. Models were adjusted for age, gender, education, smoking status, body mass index, economic status, and, in South Africa, HIV status.

resultsWe included 29 397 individuals, of whom 4916 (16.7%) died during the study period. The median follow-up time ranged from 4.6 years in South Africa to 8.3 years in China. The adjusted all-cause mortality rate ratios for people with diabetes versus those without diabetes ranged from 1.53 (95% CI: 1.39 to 1.68) in the USA to 2.02 (95% CI: 1.34 to 3.06) in Mexico. The adjusted mortality rate differences (per 1000 person-years) for people with diabetes vers those without diabetes ranged from 11.9 (95% CI: 4.8 to 18.9) in England to 24.6 (95% CI: 12.2 to 37.0) in South Africa.

conclusionsDiabetes 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.

Indexed as

AgingDiabetes MellitusMortalityAgedAged, 80 and overCause of DeathChinaEnglandFemaleFollow-Up StudiesHumansLongitudinal StudiesMaleMexicoMiddle AgedRisk FactorsDiabetes Mellitus, Type 2EpidemiologyGeriatricsInternal Medicine

Identifiers

PMID40101978
PMCPMC11931896

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.