Danaei G et al. (2006) Global and regional mortality from ischaemic heart disease and stroke attributable to higher-than-optimum blood glucose concentration: comparative risk assessment. Lancet 368: 1651–1659
Previous estimates of mortality due to diabetes or high blood-glucose levels have typically excluded deaths from cardiovascular disease, although cardiovascular disease is the most common cause of death in diabetic patients. Danaei et al. assembled a database of blood-glucose levels stratified by age, sex, and country, and used it to estimate the worldwide number of deaths from stroke and ischemic heart disease that are attributable to high blood-glucose levels.
The database included 65 data sources from 52 countries. In 2001, 959,000 deaths were directly attributed to diabetes, but, in addition, 1,490,000 deaths from ischemic heart disease and 709,000 deaths from stroke were caused by high blood-glucose levels (defined separately for each sex and age-group). The total number of deaths attributable to high blood-glucose levels, therefore, was 3.16 million, comparable to the number of deaths attributable to smoking (4.80 million), high cholesterol (3.90 million), and overweight and obesity (2.40 million). In total, 84% of the cardiovascular deaths caused by high blood glucose were in low-income and middle-income countries, mostly in the South Asia, East Asia and Pacific, and Europe and Central Asia regions.
Danaei et al. acknowledge that their estimates are limited by the quality of the data they collected: only 20 of the 52 countries included had nationally representative data, so models were used to compensate for data gaps. They recommend, however, that management programs for cardiovascular risk and diabetes should be integrated, as the two are so closely related.
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High blood-glucose levels cause millions of deaths worldwide. Nat Rev Endocrinol 3, 205 (2007). https://doi.org/10.1038/ncpendmet0415