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At least one third of all deaths at ages 35-74 in Mexico are due to diabetes, twice previous estimates, according to new research published on Thursday November 17 in The New England Journal of Medicine.

Researchers from Mexico’s National Autonomous University (UNAM) and the University of Oxford (UK), interviewed and collected blood from 150,000 men and women in Mexico City and tracked them for 12 years for mortality. Diabetes was common, affecting more than 20% by age 60 years, and was so poorly managed it greatly increased the risk of premature death from many other diseases.

In this study, people with diabetes had about four times the overall death rate of other people, whereas in high-income countries people with diabetes have only about twice the death rate of other people. Because diabetes was common and carried such a high risk, it accounted for at least one third of all deaths at ages 35-74 years.

Obesity can cause diabetes, which can cause several other diseases. The biggest excess risk of death among people with diabetes was from kidney disease, followed by heart disease, stroke, infection and acute diabetic crisis (coma from very low or high blood sugar, reflecting poor control).

On 1 November 2016 the Mexican government designated diabetes a Public Health Emergency, reinforcing its 2013 National Strategy for Obesity and Diabetes. Co-author Professor Pablo Kuri, Undersecretary for Prevention at the Mexican Health Ministry, said “Obesity and diabetes are the biggest causes of death in Mexico. Prevention is better than treatment, but this study shows that people with diabetes need much better medical management.”

Co-author Dr Jonathan Emberson, University of Oxford (UK), said “Diabetes is shortening lifespan among millions of working-age Mexicans. The risks for people with diabetes can be greatly reduced by inexpensive drugs to control blood sugar, blood pressure and cholesterol.”

Co-author Dr William Herrington, University of Oxford (UK), said “Diabetes is increasing worldwide, and in Mexico the main way it causes death is from kidney disease. Effective treatment for diabetes is much more affordable than dialysis for kidney failure.”