The Changing Nature of Mortality and Morbidity in Patients with Diabetes

The number of adults living with diabetes has increased substantially globally over the past 40 years, driven by a combination of increased age-standardized prevalence, population growth, aging, and increases in obesity prevalence. Patients with diabetes in high-income countries are living longer, with large declines in vascular disease mortality rates. This appears to be resulting in a diversification of cause of death, complications, and comorbidities that those with diabetes live with. This has large implications for prevention and management approaches, which should be reviewed to update the breadth of conditions that patients with diabetes are at excess risk of throughout their life. These trends have not yet been seen in low- and middle-income countries, where evidence is also more scarce.