Complete Health Indicator Report of Deaths due to Diabetes as Underlying Cause
Definition
Diabetes as the underlying cause of death refers to the first-listed cause of death with ICD-10 codes E10-E14.Numerator
Number of deaths with diabetes as the underlying cause of death.Denominator
Number of Utah residents.Why Is This Important?
Diabetes is a leading cause of disability and death. It is currently the seventh leading cause of death in the U.S.Healthy People Objective D-2.1:
(Developmental) Reduce the rate of all-cause mortality among the population with diabetesU.S. Target: Developmental
How Are We Doing?
Utah death rates from diabetes were in decline from 1999 to 2008. From 2009 to 2017 death rates from diabetes have remained relatively the same. However, since 2018 the death rates have been increasing slightly.How Do We Compare With the U.S.?
Between 1999 to 2008 rates for diabetes deaths in Utah were consistently higher than those for the U.S. However, since 2008 Utah had similar death rates for diabetes compared to the U.S. Age-adjusted rates are used in this indicator to account for the differences in age composition between the U.S. and Utah. In 2017, in the U.S., the age-adjusted rate was 21.5 per 100,000 population. For Utah in 2018 the rate was 23.5. In 2018, diabetes was listed as the underlying cause for 629 deaths in Utah.What Is Being Done?
Diabetes educators play a prominent role in providing information about nutrition, exercise, and blood glucose monitoring. Diabetes education for all people with diabetes is encouraged. The Healthy Environments Active Living ([https://heal.health.utah.gov/ HEAL]) Program promotes diabetes education throughout the state. Staff from the HEAL Program meet with representatives from local health insurance plans to discuss opportunities for quality improvement in treatment for their clients with diabetes. The HEAL program is working statewide to increase the number of locations that offer DSME and also promote DSME to eligible participants. National DPP is also an evidence-based program to prevent type 2 diabetes. The HEAL program works with statewide partners to promote the National DPP to eligible Utahns and also is working to expand National DPP sites across the state.Evidence-based Practices
Diabetes Self-Management Education and Support ([https://www.cdc.gov/diabetes/managing/education.html DSMES]) has been shown to improve blood glucose control in people with diabetes. Education programs may be certified by the American Diabetes Association or the Association of Diabetes Care and Education Specialists. A list of DSMES programs available in Utah is available at [https://livingwell.utah.gov/program.php?grp=diab] or [https://heal.health.utah.gov/dsmes-programs/].Available Services
The [https://health.utah.gov/ Utah Department of Health] has a Health Resource hotline: 1-888-222-2542. Please call this number for information about self-management programs in Utah. The Healthy Environments Active Living ([https://heal.health.utah.gov/ HEAL]) website provides information on diabetes self-management classes. [https://www.diabetes.org/ American Diabetes Association][[br]] 888-DIABETES [https://www.diabeteseducator.org/ Association of Diabetes Care & Education Specialists] [[br]] 800-338-3633[[br]] Local Chapter: [https://www.facebook.com/aadeutah/] [https://www.heart.org/ American Heart Association][[br]] 1937 S. 300 W. #120[[br]] Salt Lake City, UT 84115[[br]] (801) 484-3838 or[[br]] 1-800-242-8721[[br]] Also see a list of [https://livingwell.utah.gov/program.php?grp=diab diabetes education classes in Utah], and a list of [https://livingwell.utah.gov/program.php?topic=ndpp diabetes prevention classes in Utah].Health Program Information
Staff from the [https://heal.health.utah.gov/ HEAL] Program work with health care providers, including diabetes educators, dietitians, pharmacists, community health centers, community health workers, work-sites, and health plans to improve the care provided to Utahns with diabetes. Originally known as EPICC, (The Healthy Living through Environment, Policy, and Improved Clinical Care Program), the Healthy Environments Active Living (HEAL) Program is a program within the Utah Department of Health Bureau of Health Promotion. HEAL focuses on enabling education and engaged change for public health by engaging its three main audiences: individuals, partners, and decision-makers. HEAL champions public health initiatives and addresses the challenges of making health awareness and access truly universal and equitable in eight key areas: nutrition, heart health, diabetes, physical activity, schools, child care, community health workers, and worksites.Related Indicators
Relevant Population Characteristics
In 2019, diabetes was the seventh leading cause of death in Utah. People of minority races (particularly American Indian and Pacific Islander) had an increased risk of dying from diabetes.Related Relevant Population Characteristics Indicators:
- Daily Fruit Consumption
- Daily Vegetable Consumption
- Deaths due to Diabetes as Underlying Cause
- Diabetes: Gestational Diabetes
- Diabetes Hemoglobin A1C Tests
- Diabetes Prevalence
- Deaths From All Causes
- HEDIS (Healthcare Effectiveness Data and Information Set) Measures: Diabetes Care - Hemoglobin A1c (A1C)
- Obesity Among Adults
- Obesity in Pregnancy
- Overweight or Obese
- Physical Activity: Recommended Aerobic Activity Among Adults
- Physical Activity: Recommended Muscle-strengthening Among Adults
- Prediabetes
Health Care System Factors
Regular check-ups and laboratory exams are essential for detecting early signs of complications. With adequate preventive care and regular routine physician visits, some diabetes deaths could be prevented. Many diabetes-related problems, such as hypertension and early end-stage renal disease, go undetected and are diagnosed only after serious complications have developed. This issue is particularly pronounced among people without insurance who often do not have the resources to seek regular, routine care for their diabetes.Related Health Care System Factors Indicators:
Risk Factors
Risk factors for diabetes include age, obesity, sedentary lifestyle, family history, hypertension, and dyslipidemia. The more risk factors a person has, the greater his or her chance of developing diabetes. Prediabetes is a condition in which a person's blood sugar levels are elevated but not quite high enough to meet the clinical threshold for diabetes. Unless steps are taken, most people with prediabetes will develop type 2 diabetes. Having had gestational diabetes during pregnancy is also a risk factor for developing type 2 diabetes.Related Risk Factors Indicators:
Health Status Outcomes
Uncontrolled diabetes can lead to debilitating health problems. People with diabetes have an excess risk for kidney failure, blindness, non-traumatic lower extremity amputations, and neuropathy (nerve damage). People with diabetes are more likely to report their health as "fair" or "poor" than people without diabetes.Related Health Status Outcomes Indicators:
Graphical Data Views
Diabetes as an Underlying Cause of Death by Local Health District, Utah 2016-2020
The estimates for the local health districts use five years of combined data so that reliable estimates could be obtained.
There was considerable variation in age-adjusted death rates by local health districts. TriCounty, San Juan, and Tooele had the highest rates.
| Local Health District | Age-adjusted Rate per 100,000 Population | Lower Limit | Upper Limit | |||
|---|---|---|---|---|---|---|
Record Count: 14 | ||||||
| Bear River | 27.1 | 23.4 | 31.1 | |||
| Central | 32.2 | 27.1 | 38.1 | |||
| Davis County | 22.5 | 20.1 | 25.2 | |||
| Salt Lake County | 26.4 | 24.9 | 27.9 | |||
| San Juan | 34.3 | 22.6 | 50.0 | |||
| Southeast | 23.2 | 17.5 | 30.2 | |||
| Southwest | 19.6 | 17.4 | 21.9 | |||
| Summit | 7.7 | 4.0 | 13.5 | |||
| Tooele | 32.7 | 25.7 | 41.0 | |||
| TriCounty | 34.1 | 27.2 | 42.3 | |||
| Utah County | 23.0 | 20.9 | 25.4 | |||
| Wasatch | 14.0 | 8.0 | 22.8 | |||
| Weber-Morgan | 28.2 | 25.2 | 31.3 | |||
| State of Utah | 24.8 | 23.9 | 25.7 | |||
Data Notes
Age-adjusted to the 2000 U.S. standard population using 11 age groups.Data Sources
- Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2020
- U.S. Underlying Cause of Death Data: WONDER Online Database. Centers for Disease Control and Prevention, National Center for Health Statistics. Accessed at [http://wonder.cdc.gov/ucd-icd10.html]
- Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
Diabetes as an Underlying Cause of Death by Utah Small Area, 2014-2020
Because the number of deaths from diabetes is relatively small, this chart uses seven years of death data to obtain reliable death rates. Still, a number of small areas (11) have estimates that do not meet UDOH standards for reliability.
| Utah Small Areas | Age-adjusted Rate per 100,000 Population | Lower Limit | Upper Limit | Note | ||
|---|---|---|---|---|---|---|
Record Count: 100 | ||||||
| Brigham City | 35.5 | 27.1 | 45.6 | |||
| Box Elder Co (Other) V2 | 29.2 | 18.1 | 44.6 | |||
| Tremonton | 32.7 | 22.3 | 46.3 | |||
| Logan V2 | 28.4 | 22.2 | 35.8 | |||
| North Logan | 23.3 | 15.1 | 34.3 | |||
| Cache (Other)/Rich (All) V2 | 25.2 | 17.0 | 36.0 | |||
| Hyrum | 25.7 | 10.6 | 52.0 | *Interpret with caution | ||
| Smithfield | 18.8 | 9.9 | 32.6 | |||
| Ben Lomond | 29.5 | 24.1 | 35.7 | |||
| Weber County (East) | 18.8 | 13.8 | 25.0 | |||
| Morgan County | 12.0 | 4.8 | 24.9 | *Interpret with caution | ||
| Ogden (Downtown) | 37.4 | 29.5 | 46.8 | |||
| South Ogden | 25.1 | 19.3 | 32.0 | |||
| Roy/Hooper | 27.3 | 21.5 | 34.3 | |||
| Riverdale | 34.2 | 26.5 | 43.4 | |||
| Clearfield Area/Hooper | 33.3 | 26.6 | 41.2 | |||
| Layton/South Weber | 27.3 | 22.4 | 33.0 | |||
| Kaysville/Fruit Heights | 16.5 | 11.3 | 23.4 | |||
| Syracuse | 21.7 | 12.6 | 34.8 | |||
| Centerville | 18.0 | 11.3 | 27.1 | |||
| Farmington | 14.8 | 8.3 | 24.4 | |||
| North Salt Lake | 12.4 | 6.4 | 21.7 | |||
| Woods Cross/West Bountiful | 20.1 | 9.2 | 38.1 | *Interpret with caution | ||
| Bountiful | 24.5 | 20.0 | 29.8 | |||
| SLC (Rose Park) | 39.9 | 30.8 | 50.7 | |||
| SLC (Avenues) | 7.7 | 4.2 | 12.9 | |||
| SLC (Foothill/East Bench) | 11.3 | 7.2 | 16.9 | |||
| Magna | 42.8 | 31.4 | 57.1 | |||
| SLC (Glendale) V2 | 57.9 | 44.1 | 74.6 | |||
| West Valley (Center) | 45.9 | 37.7 | 55.5 | |||
| West Valley (West) V2 | 52.6 | 37.2 | 72.1 | |||
| West Valley (East) V2 | 36.4 | 29.3 | 44.6 | |||
| SLC (Downtown) V2 | 27.6 | 21.1 | 35.6 | |||
| SLC (Southeast Liberty) | 21.6 | 13.9 | 31.9 | |||
| South Salt Lake | 49.5 | 38.9 | 62.0 | |||
| SLC (Sugar House) | 26.5 | 20.6 | 33.7 | |||
| Millcreek (South) | 8.8 | 5.5 | 13.3 | |||
| Millcreek (East) | 14.7 | 9.9 | 21.2 | |||
| Holladay V2 | 19.3 | 14.5 | 25.3 | |||
| Cottonwood | 16.4 | 12.7 | 20.9 | |||
| Kearns V2 | 48.0 | 37.2 | 61.0 | |||
| Taylorsville (E)/Murray (W) | 34.5 | 27.2 | 43.1 | |||
| Taylorsville (West) | 28.1 | 21.3 | 36.4 | |||
| Murray | 29.2 | 22.8 | 36.7 | |||
| Midvale | 35.8 | 27.8 | 45.5 | |||
| West Jordan (Northeast) V2 | 25.2 | 17.5 | 35.1 | |||
| West Jordan (Southeast) | 28.5 | 20.5 | 38.5 | |||
| West Jordan (W)/Copperton | 33.7 | 21.0 | 51.2 | |||
| South Jordan V2 | 25.9 | 19.8 | 33.2 | |||
| Daybreak | 30.6 | 15.6 | 53.7 | |||
| Sandy (West) | 22.8 | 16.5 | 30.7 | |||
| Sandy (Center) V2 | 22.6 | 15.9 | 31.1 | |||
| Sandy (Northeast) | 13.1 | 8.2 | 19.9 | |||
| Sandy (Southeast) | 11.9 | 7.0 | 18.8 | |||
| Draper | 20.6 | 13.4 | 30.4 | |||
| Riverton/Bluffdale | 31.1 | 22.8 | 41.3 | |||
| Herriman | 30.1 | 18.5 | 46.1 | |||
| Tooele County (Other) | 23.8 | 14.3 | 37.1 | |||
| Tooele Valley | 34.2 | 27.2 | 42.6 | |||
| Eagle Mountain/Cedar Valley | 16.5 | 6.4 | 34.7 | *Interpret with caution | ||
| Lehi | 25.5 | 18.6 | 34.1 | |||
| Saratoga Springs | 22.9 | 10.4 | 43.9 | *Interpret with caution | ||
| American Fork | 29.2 | 22.3 | 37.6 | |||
| Alpine | 11.0 | 4.0 | 24.1 | *Interpret with caution | ||
| Pleasant Grove/Lindon | 24.8 | 18.8 | 32.1 | |||
| Orem (North) | 28.5 | 20.9 | 38.2 | |||
| Orem (West) | 26.8 | 19.6 | 35.9 | |||
| Orem (East) | 23.3 | 16.4 | 32.0 | |||
| Provo/BYU | 18.0 | 13.3 | 23.9 | |||
| Provo (West City Center) | 37.3 | 27.1 | 50.1 | |||
| Provo (East City Center) | 23.2 | 12.5 | 39.5 | |||
| Salem City | 21.2 | 10.5 | 38.3 | *Interpret with caution | ||
| Spanish Fork | 21.9 | 15.1 | 30.7 | |||
| Springville | 25.4 | 18.0 | 34.8 | |||
| Mapleton | 16.1 | 6.8 | 32.2 | *Interpret with caution | ||
| Utah County (South) V2 | 33.1 | 18.5 | 54.5 | |||
| Payson | 30.1 | 20.9 | 42.0 | |||
| Park City | 6.2 | 2.2 | 13.6 | *Interpret with caution | ||
| Summit County (East) | 21.7 | 11.8 | 36.5 | |||
| Wasatch County | 21.3 | 14.6 | 29.9 | |||
| Daggett and Uintah County | 37.8 | 29.9 | 47.1 | |||
| Duchesne County | 39.9 | 29.3 | 53.1 | |||
| Nephi/Mona | 16.5 | 7.0 | 32.8 | *Interpret with caution | ||
| Delta/Fillmore | 16.2 | 8.5 | 28.0 | |||
| Sanpete Valley | 15.1 | 9.3 | 23.2 | |||
| Central (Other) | 39.9 | 31.3 | 50.1 | |||
| Richfield/Monroe/Salina | 45.1 | 33.8 | 59.1 | |||
| Carbon County | 32.9 | 24.6 | 43.2 | |||
| Emery County | 15.1 | 7.4 | 27.4 | *Interpret with caution | ||
| Grand County | 13.4 | 6.7 | 23.8 | |||
| Blanding/Monticello | 32.6 | 19.2 | 51.8 | |||
| San Juan County (Other) | 44.3 | 27.0 | 68.4 | |||
| St. George | 21.1 | 18.0 | 24.5 | |||
| Washington Co (Other) V2 | 23.0 | 14.3 | 35.0 | |||
| Washington City | 16.0 | 10.6 | 23.0 | |||
| Hurricane/La Verkin | 24.0 | 17.4 | 32.2 | |||
| Ivins/Santa Clara | 23.0 | 15.2 | 33.3 | |||
| Cedar City | 20.0 | 14.8 | 26.3 | |||
| Southwest LHD (Other) | 22.5 | 16.6 | 29.9 | |||
| State of Utah | 25.6 | 24.9 | 26.4 | |||
Data Notes
Age-adjusted to the 2000 U.S. standard population using 11 age groups. *Unreliable Estimates: Use caution in interpreting; the estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health standards. A description of the Utah Small Areas may be found on the [https://ibis.health.utah.gov/resource/Guidelines.html Methodology and Guidelines page].Data Sources
- Population estimates produced by the UDOH Center for Health Data and Informatics. Linear interpolation of U.S. Census Bureau and ESRI ZIP Code data provided annual population estimates for ZIP Code areas by sex and age groups, IBIS Version 2020
- Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
Diabetes as an Underlying Cause of Death, Utah and U.S., 1999-2020
Diabetes death rates in Utah, in general, exceed U.S. diabetes death rates. Utah death rates from diabetes were in decline from 1999 to 2008. From 2009 to 2017 death rates from diabetes remained fairlly constant. . However, since 2018 the death rates have been increasing slightlly in Utah.
| Utah vs. U.S. | Year | Age-adjusted Rate per 100,000 Population | Lower Limit | Upper Limit | ||
|---|---|---|---|---|---|---|
Record Count: 43 | ||||||
| Utah | 1999 | 31.9 | 29.0 | 34.9 | ||
| Utah | 2000 | 34.3 | 31.4 | 37.4 | ||
| Utah | 2001 | 32.2 | 29.4 | 35.1 | ||
| Utah | 2002 | 31.8 | 29.1 | 34.7 | ||
| Utah | 2003 | 31.3 | 28.6 | 34.1 | ||
| Utah | 2004 | 28.6 | 26.1 | 31.3 | ||
| Utah | 2005 | 30.9 | 28.3 | 33.6 | ||
| Utah | 2006 | 26.8 | 24.5 | 29.3 | ||
| Utah | 2007 | 28.6 | 26.2 | 31.1 | ||
| Utah | 2008 | 23.8 | 21.6 | 26.0 | ||
| Utah | 2009 | 22.3 | 20.3 | 24.5 | ||
| Utah | 2010 | 22.4 | 20.4 | 24.6 | ||
| Utah | 2011 | 25.8 | 23.7 | 28.0 | ||
| Utah | 2012 | 24.6 | 22.6 | 26.8 | ||
| Utah | 2013 | 25.4 | 23.4 | 27.6 | ||
| Utah | 2014 | 24.2 | 22.3 | 26.4 | ||
| Utah | 2015 | 24.7 | 22.8 | 26.8 | ||
| Utah | 2016 | 24.6 | 22.7 | 26.6 | ||
| Utah | 2017 | 22.9 | 21.1 | 24.8 | ||
| Utah | 2018 | 23.5 | 21.7 | 25.4 | ||
| Utah | 2019 | 25.0 | 23.1 | 26.9 | ||
| Utah | 2020 | 27.3 | 25.4 | 29.3 | ||
| U.S. | 1999 | 25.0 | 24.8 | 25.2 | ||
| U.S. | 2000 | 25.0 | 24.9 | 25.2 | ||
| U.S. | 2001 | 25.4 | 25.2 | 25.5 | ||
| U.S. | 2002 | 25.6 | 25.4 | 25.8 | ||
| U.S. | 2003 | 25.5 | 25.3 | 25.7 | ||
| U.S. | 2004 | 24.7 | 24.6 | 24.9 | ||
| U.S. | 2005 | 24.9 | 24.8 | 25.1 | ||
| U.S. | 2006 | 23.6 | 23.4 | 23.7 | ||
| U.S. | 2007 | 22.8 | 22.6 | 22.9 | ||
| U.S. | 2008 | 22.0 | 21.9 | 22.2 | ||
| U.S. | 2009 | 21.0 | 20.9 | 21.2 | ||
| U.S. | 2010 | 20.8 | 20.7 | 21.0 | ||
| U.S. | 2011 | 21.6 | 21.5 | 21.8 | ||
| U.S. | 2012 | 21.2 | 21.0 | 21.3 | ||
| U.S. | 2013 | 21.2 | 21.0 | 21.3 | ||
| U.S. | 2014 | 20.9 | 20.8 | 21.1 | ||
| U.S. | 2015 | 21.3 | 21.1 | 21.4 | ||
| U.S. | 2016 | 21.0 | 20.9 | 21.2 | ||
| U.S. | 2017 | 21.5 | 21.3 | 21.6 | ||
| U.S. | 2018 | 21.4 | 21.2 | 21.5 | ||
| U.S. | 2019 | 21.4 | 21.4 | 21.7 | ||
Data Notes
Age-adjusted to the 2000 U.S. standard population using 11 age groups.Data Sources
- Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2020
- Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
- U.S. Underlying Cause of Death Data: WONDER Online Database. Centers for Disease Control and Prevention, National Center for Health Statistics. Accessed at [http://wonder.cdc.gov/ucd-icd10.html]
Diabetes as an Underlying Cause of Death by Race, Utah, 2018-2020
American Indian and Native Hawaiian/Pacific Islander Utahns had exceptionally high death rates due to diabetes.
| Race | Age-adjusted Rate per 100,000 Population | Lower Limit | Upper Limit | |||
|---|---|---|---|---|---|---|
Record Count: 6 | ||||||
| American Indian/Native Alaskan | 55.8 | 40.9 | 74.3 | |||
| Asian | 14.7 | 9.7 | 21.5 | |||
| Black | 33.5 | 20.2 | 52.3 | |||
| Pacific Islander | 94.6 | 70.9 | 123.6 | |||
| White | 23.3 | 22.2 | 24.3 | |||
| All Races | 24.1 | 23.1 | 25.2 | |||
Data Notes
All races may be of Hispanic/Latino or non-Hispanic/Latino ethnicity.[[br]] Data shown are for 2018-2020 (combined years) and age-adjusted to the 2000 U.S. standard population using 3 age groups.Data Sources
- Population Estimates by Age, Sex, Race, and Hispanic Origin for Counties in Utah, U.S. Bureau of the Census, IBIS Version 2019
- Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
Death Rates for Diabetes as an Underlying Cause of Death by Ethnicity, Utah, 2020
The diabetes death rate is statistically similar among Hispanics and Non-Hispanics.
| Hispanic Ethnicity | Age-adjusted Rate per 100,000 Population | Lower Limit | Upper Limit | |||
|---|---|---|---|---|---|---|
Record Count: 3 | ||||||
| Hispanic | 24.0 | 17.8 | 31.7 | |||
| Non-Hispanic | 26.0 | 24.1 | 27.9 | |||
| All Utahns | 25.9 | 24.1 | 27.7 | |||
Data Notes
Age-adjusted to the 2000 U.S. population using 11 age groups.Data Sources
- Population Estimates by Age, Sex, Race, and Hispanic Origin for Counties in Utah, U.S. Bureau of the Census, IBIS Version 2020
- Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
References and Community Resources
[https://www.diabetes.org American Diabetes Association][[br]] [[br]] [https://www.cdc.gov/diabetes/index.html Division of Diabetes Translation], Centers for Disease Control and Prevention[[br]] [[br]] [https://wonder.cdc.gov/ CDC Wonder] Association of Diabetes Care & Education Specialists [[br]] [http://www.diabeteseducator.org][[br]] [https://www.facebook.com/aadeutah Local Chapter Facebook Page]More Resources and Links
Evidence-based community health improvement ideas and interventions may be found at the following sites:Additional indicator data by state and county may be found on these Websites:
- CDC Prevention Status Reports for all 50 states
- County Health Rankings
- Kaiser Family Foundation's StateHealthFacts.org
- CDC WONDER DATA2010, the Healthy People 2010 Database.
Medical literature can be queried at the PubMed website.
Page Content Updated On 10/28/2021,
Published on 11/18/2021
