Background: Mortality trends among people with diabetes in developing countries have not been well evaluated. We aimed to assess and compare recent trends in all-cause and cardiovascular mortality in people with and without diabetes.

Methods: From a population-based cohort (2003-2013) provided by the National Health Insurance Service in Korea, we evaluate annual mortality rates from all-cause and cardiovascular diseases in adults (≥30 years) with and without diabetes. The total number of subjects in this analysis ranged from 585,795 in 2003 to 670,020 in 2013.

Results: Age and sex-adjusted all-cause mortality rates decreased consistently in both groups from 2003 to 2013 (from 14.5 to 9.4/1,000 persons in subjects with diabetes and from 7.9 to 4.4/1,000 persons in those without diabetes; p for trend < 0.001 in both groups). The difference in mortality rate between groups also decreased (+6.61/1,000 persons in 2003 to +4.98/1,000 persons in 2013). The slope associated with the mortality rate exhibited a steeper decrease in subjects with diabetes than those without diabetes (regression coefficients of time: −0.50, and −0.33, respectively; p = 0.004). In subjects with diabetes, the mortality rate from cardiovascular disease decreased by 53.5% during the study period; the decrease in mortality from ischemic stroke (79.2%) was more profound than that from ischemic heart disease (28.3%).

Conclusion: The all-cause and cardiovascular mortality rates decreased substantially from 2003 to 2013 among Korean adults with diabetes. The decreased cardiovascular mortality in diabetes was mainly due to the decrease in ischemic stroke-related mortality.

10-year trends in all-cause and cardiovascular mortality among people with and without diabetes in Korea, 2003–2013