All-cause mortality attributable to type 2 diabetes mellitus in Peru: a comparative risk assessment analysis

Objectives. To quantify all-cause mortality attributable to type 2 diabetes mellitus (T2DM) across the 25 regions of Peru using a comparative risk assessment approach. Materials and methods. We estimated population attributable fractions (PAFs) by combining T2DM prevalence from the Peruvian Demographic and Health Survey (ENDES) with relative risks (RRs) for the association between T2DM and all-cause mortality. Sex-, age-, and region-specific PAFs were multiplied by the number of registered deaths in 2018 to obtain the absolute number and proportion of deaths attributable to T2DM in each region. Results. In 2018, an estimated 19,102 deaths were attributable to T2DM, corresponding to 16.6% of all-cause deaths among adults aged ≥ 20 years. The burden was slightly higher among men (9,985 deaths; 8.7% of all-cause deaths) than among women (9,117 deaths; 7.9%). The highest proportions and absolute numbers of deaths attributable to T2DM were observed in Lima, Lambayeque, and Callao (all coastal regions), whereas the lowest estimates were found in Pasco, Madre de Dios, and Amazonas. Lima concentrated the largest number of T2DM-attributable deaths and the highest age-standardized mortality rates. Conclusions. T2DM is a major contributor to all-cause mortality in Peru, particularly in Lima and other coastal regions. National and regional policies should prioritize T2DM prevention, early detection, and access to effective treatment to reduce this mortality burden.