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Abstract
Aims We investigated whether the UK has higher child and youth diabetes mortality than in comparable European countries and the USA.
Methods We obtained data from the WHO World Mortality Database for the UK, the USA and the EU15+ (the 15 countries of the EU in 2004 plus Australia, Canada and Norway) for 1990 to 2010. Diabetes mortality rates were calculated for 1–14 and 15–24 year olds. Multilevel longitudinal Poisson regression models were constructed including all country-level data from 1990–2010 (378 country years) comparing the UK with the EU15+ and the USA. Graphics show average mortality across the EU15+.
Results Mortality trends are shown in Figure 1 for 1–14 year olds (both sexes) and Figure 2 (males) and Figure 3 (females) for 15–24 year olds. In 1990 the UK had higher mortality than the EU15+ amongst 1–14yo (p = 0.004) but not amongst 15–24yo (p > 0.2 both sexes). Diabetes mortality did not significantly change in the EU15+ across the study period in any age group. In contrast, amongst 1–14 year olds the UK had a significantly higher rate of decline than the EU15+ (negative slope coefficient, p = 0.03). UK mortality rose amongst 15–24 year olds compared with the EU15+ (positive slope coefficients, p < 0.0001 both sexes) In 1990, the UK had higher diabetes mortality than the US in 1–14 year olds (p < 0.0001) but lower amongst 15–24 year olds (p < 0.0001 both sexes). The USA had little change in diabetes mortality amongst 1–14 year olds but a significant rise in diabetes mortality amongst 15–24 year olds (p < 0.0001 both sexes). The UK had a greater rate of mortality decline that the USA amongst 1–14 year olds (negative slope coefficient p < 0.0001) but rising mortality amongst 15–24 year olds (positive slope, p < 0.0001 both sexes).
Total diabetes mortality amongst 1–14 year olds (3 year moving averages)
Total diabetes mortality amongst 15–24 year males (3 year moving averages)
Total diabetes mortality amongst 15–24 year females (3 year moving averages)
Discussion Diabetes mortality in the UK for children 1–14 years approximates the EU15+ mean and is better than in the USA. However, for 15–24 year olds, the UK has high and rising diabetes mortality compared with the EU15+ from 2000 onwards. Further work is needed to understand the contributions of healthcare factors to the UK’s poor diabetes mortality record amongst young people.