Mortality-to-Incidence Ratio of Diabetes Mellitus: 2018 – 2024 Progress Radar in Belgrade (Serbia)
M M Šantrić Milićević, N Rosić, A Rommel, A Anton, M Vujetić, G Tamburkovski, Š Cilović-Lagarija, S SkočibušićAbstract
Background
The mortality-to-incidence ratio (MIR) can be used to monitor the progress of diabetes mellitus (DM) management. This study assesses changes in the MIR for DM in the Belgrade population (≈1.7 million) from 2018 to 2024.
Methods
Population size, life expectancy (LE), registered DM deaths and incidence (International Classification of Diseases, ICD-X: E10-11) from anonymized population registries of the Belgrade City Institute of Public Health (2018-2024), were analyzed to assess MIR, age-standardized incidence, mortality and YLL rates per 100,000 (ASIR, ASMR and ASYLLR), stratified by sex and age (in eighteen five-year age intervals), along with average annual percentage changes. Standard LE (2021) and the World Population Age Standard (2021) were sourced from the Global Burden of Disease Study.
Results
The DM incidence and ASIR showed significant variability, ranging from 1,160 cases (45.4/ 100,000) in 2018 to 2,037 cases (71.0/100,000) in 2024. The annual incidence increased by 38.5%, while mortality rose by 7.3% per year, from 513 cases (15.0/100,000) to 759 cases (21.3/100,000). ASIR and ASMR increased overall by 31.3% and 6.6% (in the age group 65-74 years: 67.5% and 11.2%). YLL increased by 6.6%, from 9,107 in 2018 (279/100,000) to 12,976 in 2024 (388/100,000). The ASYLLR for persons over 65 years of age was nearly double that of younger people. The MIR rose by 32.9%. Incidence and death counts were higher for women (age ≥65 years), but men (aged 15-64 years) showed faster increases in ASIR, ASMR, YLL, and ASYLLR.
Conclusions
The rise in ASIR and ASMR, along with MIR, indicates that the Belgrade population, especially men and working-age people, needs targeted DM management and control.
Key messages
• Tracking changes in premature mortality, along with the incidence of diabetes mellitus, is essential for the formulation of targeted health strategies.
• Healthcare stakeholders should tailor diabetes management and prevention for the working-age population, as their mortality-to-incidence ratio indicates an increasing trend.