Reporting of diabetes on death certificates of 1872 people with type 2 diabetes in Tayside, Scotland

Background: It has been suggested that diabetes is under-recorded on death certificates. Methods: We examined the death certificates of 1,872 people with type 2 diabetes in Tayside, Scotland, to determine how frequently diabetes was recorded. Results: Diabetes was mentioned on the certificates of 42.8% and was the underlying cause of death for 6.4%. There was mention of diabetes for 51.3% of the 811 people for whom cardiovascular disease was the underlying cause of death. Being male was associated with less frequent mention of diabetes, with more frequent mention associated with increasing duration of diabetes, increasing age and underlying cardiovascular cause of death. Conclusions: This study highlights the limitations of using routine mortality data for monitoring the burden of diabetes in populations.