Time Trend, Age and Sex Distribution of Deceased from Diabetes Mellitus at the Regional Level in the Slovak Republic.

AIM: To describe the time trends, age and sex distribution of death from diabetes mellitus (E10-E14) as a significant part of endocrine, nutritional and metabolic diseases (E00-E90), during 1996-2014 in the Slovak regions, and to estimate the influence of social characteristics on mortality.

METHODS: Secondary data on deaths during 1996-2014 were gathered from the National Health Information Center in the Slovak Republic. The total crude death rate per 100,000 of the standard Slovak population and age-standardized death rate per 100,000 of the standard European population were calculated by direct standardization. Multilevel logistic regression analysis was performed.

RESULTS: Deaths from diabetes mellitus account for 91.6% of deaths registered in the endocrine, nutritional and metabolic diseases Chapter. The age-standardized death rate per 100,000 of inhabitants decreased from 19.2 in 1996 to 15.3 in 2014 in the Slovak Republic, although a massive increase of up to 32.5 was reported in 1999. The highest age-standardized death rates per 100,000 inhabitants were typical for the Košice, Nitra and Trenčín regions. On the other hand, the lowest counts were recorded in the Bratislava region. Mortality from diabetes mellitus starts to be evident in the 45-49 year age-group in both sexes. The median age of death for women is lower in the 75-79 year age-group in comparison to men although the total crude death rate for men in lower age groups is higher. After age 80 the situation is reversed. The odds of dying due to endocrine, nutritional and metabolic diseases decreases by 0.4% each year. The odds of dying are lower by 17% and 12.3%, respectively, in the Žilina and Prešov regions compared to Bratislava region. Women have a higher probability of dying by 38% in contrast to men, and married couples by 16.7% than singles. Age is proved to be an insignificant factor.

CONCLUSIONS: In spite of the declining trend of mortality from diabetes mellitus, it is necessary to reduce the risk of its incidence by healthier food consumption and physical activity.