Diabetes and its complications are major causes of early death in most countries. Cardiovascular disease (Chapter 'What is Diabetes' ) is one of the leading causes of death for people with diabetes and can account for 50% or more of deaths due to diabetes in some populations. Estimating the number of deaths due to diabetes is challenging because more than a third of countries do not have any data on diabetes-related mortality and also because existing routine health statistics underestimate the number of deaths due to diabetes. To provide a more realistic estimate of mortality, a modelling approach is used in the IDF Diabetes Atlas to estimate the number of deaths that can be attributed to diabetes in 2011.
Burden of mortality due to diabetes
Some 4.6 million people 20-79 years of age died from diabetes in 2011, accounting for 8.2% of global all-cause mortality of people in this age group. This estimated number of deaths is similar in magnitude to the combined deaths from several infectious diseases that are major public health priorities * , and is equivalent to one death every seven seconds. Forty-eight percent of deaths due to diabetes are in people under the age of 60. The highest number of deaths due to diabetes is in countries with the largest numbers of people with diabetes — India, China, United States of America, and the Russian Federation.
There is no difference in the total number of deaths due to diabetes in men and women. However, there are important differences in the distribution of deaths for men and women.
Diabetes accounts for a higher proportion of deaths in women than in men, representing up to a quarter of all deaths in middle-aged women in all but the Middle East and North Africa, and Western Pacific Regions. This higher proportion is due to a higher rate of mortality from other causes in men than in women.
The number of deaths attributable to diabetes in 2011 shows a 13.3% increase over the estimates for the year 2010. 1 2 This increase is largely due to increases in the number of deaths due to diabetes in the South and Central America, Western Pacific, North America and Caribbean, and Middle East and North Africa Regions. This can be explained by a rise in diabetes prevalence in some highly populated countries in each region. While there has been a documented decline of the mortality due to some non-communicable diseases in some countries, 3 no such decline has been reported for diabetes.
Accuracy of mortality data
The mortality estimates in this report should be interpreted with caution. However, they are probably more realistic than estimates based on routine sources of health statistics which systematically underestimate the burden of mortality due to diabetes, largely because diabetes is often omitted from death certificates. A substantial proportion of these deaths are potentially preventable through public health action directed at primary prevention of diabetes in the population and improvement of care for all people with diabetes. 4
*: In 2009 there were 1.8 million deaths from HIV/AIDS, 781,000 from malaria  and 1.3 million from tuberculosis.
1: International Diabetes Federation. The IDF Diabetes Atlas. Fourth Edition. Brussels: International Diabetes Federation; 2009.
2: Roglic G, Unwin N. Mortality attributable to diabetes: estimates for the year 2010. Diabetes Res Clin Pract 2010; 87 (1): 15-19.
3: Tunstall-Pedoe H, Kuulasmaa K, Mähönen M, et al. Contribution of trends in survival and coronary-event rates to changes in coronary heart disease mortality: 10-year results from 37 WHO MONICA project populations. Monitoring trends and determinants in cardiovascular disease. Lancet 1999; 353 (9164): 1547-1557.
4: Colagiuri S, Borch-Johnsen K, Glümer C, et al. There really is an epidemic of type 2 diabetes. Diabetologia 2005; 48 (8): 1459-1463.
5: Joint United Nations Programme on HIV/AIDS (UNAIDS). Global report: UNAIDS report on the global AIDS epidemic 2010 UNAIDS; 2010.
6: World Health Organization. World Malaria Report: 2010 World Health Organization; 2010.
7: World Health Organization. Global tuberculosis control: 2010 Geneva: World Health Organization; 2010.