Trends of Diabetes Mortality in Iran at National and Sub-national levels from 1990 to 2015 and its association with socioeconomic factors

Abstract

Background Following global commitments to prevent and control non-communicable diseases, we sought to estimate national and sub-national trends in diabetes mortality in Iran and to assess its association with socioeconomic factors.Methods To assess the correlation between diabetes mortality and socioeconomic factors we used data obtained from the Death Registration System (DRS), the spatio-temporal model and Gaussian Process Regression (GPR) levels and the diabetes mortality trends, which were estimated by sex, age and year at national and sub-national levels from 1990 to 2015.Results Between the years 1990 and 2015, the age-standardized diabetes mortality rate (per 100,000) increased from 3.40 (95% UI: 2.33 to 4.99) to 7.72 (95% UI: 5.51 to 10.78) in males and from 4.66 (95% UI: 3.23 to 6.76) to 10.38 (95% UI: 7.54 to 14.23) in females. In 1990, the difference between the highest age-standardized diabetes mortality rate among males was 3.88 times greater than the lowest (5.97 vs. 1.54) and in 2015 this difference was 3.96 times greater (14.65 vs. 3.70). This provincial difference was higher among females and was 5.13 times greater in 1990 (8.41 vs. 1.64) and 5.04 times greater in 2015 (19.87 vs. 3.94). The rate of diabetes mortality rose with urbanization, yet declined with an increase in wealth and years of schooling as the main socio-economic factors.Conclusion The rising trend of diabetes mortality rate at national level and the sub-national disparities associated with socioeconomic status in Iran warrant the implementation of specific interventions recommended by the ‘25 by 25’ goal.