Diabetes mortality in Singapore, 1991--a preliminary study

OBJECTIVES: The study was undertaken to estimate the contribution of diabetes mellitus to total mortality in Singapore and to study the mortality experience among known diabetics in Singapore by sex, age-group and ethnic group. METHODS: Death certificates of all persons who died in Singapore between 1 January 1991 and 31 August 1991 (n = 9,197) were reviewed. Records which mentioned diabetes mellitus as an underlying or contributory cause of death were selected as being a diabetic case (n = 1,010). RESULTS: If all diabetes related deaths were considered, diabetes mellitus would account for 9.3% of all deaths in Singapore in 1991, i.e. four times higher than the figure of 2.3% in the official statistics. Ischaemic heart disease was the leading cause of death in all age-groups. Renal failure was a major cause of death before the age of 55 while cerebrovascular disease and respiratory tract infections were important causes of death after the age of 64. Renal failure was the leading cause of death among Chinese diabetics below the age of 65. Ischaemic heart disease was the main cause of death among Indian and Malay diabetics. As compared to the general population, Chinese diabetics were more likely to die from renal failure while Indian and Malay diabetics were more likely to die from ischaemic heart disease.