Underestimation of mortality from diabetes in Russia

Russia is among ten countries with the largest number of diabetic patients and with one of the lowest recorded levels of mortality. The hypothesis tested that unreported deaths from diabetes is the result of the underestimation of the importance of diabetes for the population’s health. The next factors were analyzed: the completeness of recorded diabetes in patients with in-hospital mortality, the share of records about diabetes as a concomitant disease in death certificates, the frequency of use of the code E14 (unspecified diabetes) for registration of death as well as codes that can not be the primary cause of death, and to be replaced by diabetes. The result shows that a vicious circle is formed by the serious misperception of diabetes mellitus being a danger to population’s health. The significance of diabetes being underestimated leads to the exclusion of diabetes on the medical death certificates which lead to the underestimation of mortality from diabetes. This leads to a lack of attention of health authorities to the problems of prevention and quality of medical care for patients with diabetes, and this leads to a lower estimate for the importance of diabetes mellitus in population health by health professionals on practice level.