Epidemiological Profile of Hospital Mortality Due to Diabetes and Its Complications in Mexico: A National and State-Level Analysis (2014–2024)
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Objective: To analyze the epidemiological profile and annual percentage changes from 2014 to 2024 in in-hospital mortality due to diabetes and its complications in Mexico, at the national and state levels. Methods: An observational, analytical, ecological time-series study was conducted for the 2014–2024 period. All hospital discharge records from the Automated Hospital Discharge Subsystem (SAEH) with a principal or initial diagnosis of diabetes and its complications (E10, E11, E14) were included. Descriptive and inferential statistics were applied, using Pearson’s chi-square tests (p<0.05) to assess sociodemographic, clinical, and territorial associations. Annual percentage changes were also calculated, and a spatial analysis of state-level proportional in-hospital mortality was performed. Results: Among 38,009 deaths due to diabetes mellitus and its complications, the highest values occurred in 2015–2016 (≤12% annually), with a predominance among women (51.7%), individuals aged 60 to 70 years (25.7%), and hospital stays of 1 to 10 days (76.4%; p<0.05). Renal complications were the leading cause at both the national (26.2%) and state levels (p<0.001). Deaths were concentrated in the State of Mexico, Guanajuato, and Mexico City. The highest proportional in-hospital mortality was recorded in Baja California in 2015 (10,792.07 per 100,000 discharges). Conclusion: The predominance of renal complications and the territorial heterogeneity in mortality due to diabetes mellitus in Mexico highlight the need to regionalize resources, strengthen early detection of renal complications, and optimize hospital care.
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Montoya A, Gallardo-Rincón H, Silva-Tinoco R, García-Cerde R, Razo C, Ong L, et al . Epidemia de diabetes tipo 2 en México. Análisis de la carga de la enfermedad 1990-2021 e implicaciones en la política pública. Gac. Méd. Méx. 2023;159( 6 ):488-500. DOI : 10.24875/gmm.23000378.
World Health Organization. Regional Office for Europe. Support tool to strengthen health information systems: guidance for health information system assessment and strategy development, second edition. Copenhagen: WHO Regional Office for Europe; 2024 [Internet]. [Citado 2026 Ago 28]. Disponible en: https://www.who.int/europe/publications/i/item/9789289061148
World Health Organization. Invisible numbers: the true extent of noncommunicable diseases and what to do about them. Geneva: World Health Organization; 2022. [Internet]. [Citado 2026 Ago 28]. Disponible en: https://www.who.int/publications/i/item/9789240057661
Pérez-Lozano DL, Camarillo-Nava VM, Juárez-Zepeda TE, Andrade-Pineda JE, Lucho-Gutiérrez ZM, Reyes-Pacheco JA, et al. Costo-efectividad del tratamiento de la diabetes mellitus tipo 2 en México. Rev Med Inst Mex Seguro Soc. 2023;61(2):172-180.
Rojas Montiel FM, Ayala Juárez MT, Cuéllar Vázquez JJ, Mendoza Romo MA, Alemán Alvarado CA. Calidad de vida en pacientes con diabetes mellitus tipo 2 en tratamiento con insulina. Aten Fam. 2021;28(4):275-279. DOI:10.22201/fm.14058871p.2021.4.80598.
Instituto Nacional de Salud Pública. Evaluación externa de impacto del Programa Oportunidades 2004. Cuernavaca, México: INSP; 2004. p.209-245.
International Diabetes Federation. IDF Diabetes Atlas. 10th ed. Brussels: International Diabetes Federation; 2021 [Internet]. [Citado 2026 Ago 28]. Disponible en: https://idf.org/news-and-resources/resources/idf-diabetes-atlas-2021/
American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2024. Diabetes Care. 2024;47(Suppl 1):S20-S42. DOI:10.2337/dc24-S002.
Flores-Hernández S, Acosta-Ruiz O, Hernández-Serrato MI, Delgado-Rodríguez S, Reyes-Morales H. Calidad de la atención en diabetes tipo 2, avances y retos de 2012 a 2018-19 para el sistema de salud de México . Salud Publica Mex. 2020;62(6):618-626. DOI:10.21149/11876.
Basto-Abreu A, López-Olmedo N, Rojas-Martínez R, Aguilar-Salinas CA, De la Cruz-Góngora V, Rivera-Dommarco J, et al. Prevalencia de diabetes y control glucémico en México: resultados nacionales de 2018 y 2020. Salud Publica Mex. 2021;63(6):725-733. DOI:10.21149/12842.
Gallardo-Rincón H, Ríos-Blancas MJ, Montoya A, Saucedo-Martínez R, Morales-Juárez L, Mujica R, et al. Evaluation of effective coverage for type 2 diabetes in Mexican primary care health information systems: a retrospective registry analysis. Int J Equity Health. 2023;22(1):61. DOI:10.1186/s12939-023-01878-7.
Salas-Zapata L, Palacio-Mejía LS, Aracena-Genao B, Hernández-Ávila JE, Nieto-López ES. Costos directos de las hospitalizaciones por diabetes mellitus en el Instituto Mexicano del Seguro Social. Gac Sanit. 2018;32(3):209–215. DOI:10.1016/j.gaceta.2016.06.015.
Unidad de Inteligencia en Salud Pública. Subsistema Automatizado de Egresos Hospitalarios, Secretaría de Salud: series de tiempo 2008 al 2024 [dataset on the Internet]. Cuernavaca: Instituto Nacional de Salud Pública; 2025 [Internet]. [Citado 2026 Ago 28]. Disponible en: https://riisp.insp.mx/nada/index.php/catalog/18
OPS/OMS. Clasificación Internacional Estadística de Enfermedades y Problemas relacionados con la salud. 2006 [Internet]. [Citado 2026 Ago 28]. Disponible en: https://ais.paho.org/classifications/chapters/pdf/volume1.pdf
Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, et al. Pathophysiology of Type 2 Diabetes Mellitus. Int J Mol Sci. 2020;21(17):6275. DOI: 10.3390/ijms21176275.
Samsudin N, Ibrahim R, Aizuddin AN, Hamid SN. Determinants of In-Hospital Mortality Among Type 2 Diabetes Mellitus-Related Admissions in a Tertiary Teaching Hospital. Healthcare (Basel). 2026;14(3):347. DOI: 10.3390/healthcare14030347.
Sękowski K, Grudziąż-Sękowska J, Goryński P, Pinkas J, Jankowski M. Clinical Characteristics and Factors Associated with In-Hospital Mortality in 66 755 Patients Hospitalized Due to Diabetes in Poland, January to December 2019. Med Sci Monit. 2022;28:e938550. DOI: 10.12659/MSM.938550.
Baviera M, Genovese S, Colacioppo P, Cosentino N, Foresta A, Tettamanti M, et al. Diabetes mellitus duration and mortality in patients hospitalized with acute myocardial infarction. Cardiovasc Diabetol. 2022;21(1):223. DOI: 10.1186/s12933-022-01655-w.
Munsakul N, Manosroi W, Buranapin S. Predictors and Predictive Score of In-Hospital Mortality in Diabetic Ketoacidosis: A Retrospective Cohort Study. Medicina (Kaunas). 2024;60(11):1833. DOI: 10.3390/medicina60111833.
Shang L, Shao M, Guo Q, Shi J, Zhao Y, Xiaokereti J, et al. Diabetes Mellitus is Associated with Severe Infection and Mortality in Patients with COVID-19: A Systematic Review and Meta-analysis. Arch Med Res. 2020;51(7):700-709. DOI: 10.1016/j.arcmed.2020.07.005.
Darmawan ES, Permanasari VY, Nisrina LV, Kusuma D, Hasibuan SR, Widyasanti N. Behind the Hospital Ward: In-Hospital Mortality of Type 2 Diabetes Mellitus Patients in Indonesia (Analysis of National Health Insurance Claim Sample Data). Int J Environ Res Public Health. 2024;21(5):581. DOI: 10.3390/ijerph21050581.
Mi D, Li Z, Gu H, Jiang Y, Zhao X, Wang Y, et al. Stress hyperglycemia is associated with in-hospital mortality in patients with diabetes and acute ischemic stroke. CNS Neurosci Ther. 2022;28(3):372-381. DOI: 10.1111/cns.13764.
Thewjitcharoen Y, Plianpan P, Chotjirat A, Nakasatien S, Chotwanvirat P, Wanothayaroj E, et al. Clinical characteristics and outcomes of care in adult patients with diabetic ketoacidosis: A retrospective study from a tertiary diabetes center in Thailand. J Clin Transl Endocrinol. 2019;16:100188. DOI:10.1016/j.jcte.2019.100188.
Guzman-Martinez AM, Garcia-Rodriguez O, Ramos-Melendez EO, Guerrios-Rivera L, Rodriguez-Ortiz P. Morbidity and mortality of Hispanic trauma patients with diabetes mellitus. Eur J Trauma Emerg Surg. 2020;46(4):887-893. DOI: 10.1007/s00068-018-1047-z.
Kaminska H, Szarpak L, Kosior D, Wieczorek W, Szarpak A, Al-Jeabory M, et al. Impact of diabetes mellitus on in-hospital mortality in adult patients with COVID-19: a systematic review and meta-analysis. Acta Diabetol. 2021;58(8):1101-1110. DOI: 10.1007/s00592-021-01701-1.
Rawshani A, Rawshani A, Franzén S, Sattar N, Eliasson B, Svensson AM, et al. Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2018;379(7):633-644. DOI: 10.1056/NEJMoa1800256.
Niwaha AJ, Rodgers LR, Carr ALJ, Balungi PA, Mwebaze R, Hattersley AT, et al. Continuous glucose monitoring demonstrates low risk of clinically significant hypoglycemia associated with sulphonylurea treatment in an African type 2 diabetes population: results from the OPTIMAL observational multicenter study. BMJ Open Diabetes Res Care. 2022;10(2):e002714. DOI:10.1136/bmjdrc-2021-002714.