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Diabetes was California’s seventh leading cause of death for each year from 2000 through 2008. The age-adjusted diabetes death rate was lower in California than the United States for every year from 2000 through 2007.
Decreasing diabetes death trends were observed in San Francisco, Shasta, and Ventura counties. Higher age-adjusted diabetes mortality rates were seen in men than women throughout the study period. Diabetes was California’s seventh leading cause of death for the years 2000 through 2008 and the seventh leading cause of death nationally in 20071, the most recent year for which national data is available. Diabetes disproportionately affects minority populations and the elderly, and its incidence is likely to increase as minority populations grow and the U.S.
On the other hand, heart disease and cerebrovascular disease were slightly more likely to be listed as the underlying cause than as contributing causes, and cancer was about six times more likely to be listed as the underlying cause than as a contributing cause of death.5  In 2008, there were 7,349 deaths in California with diabetes listed as the underlying cause on the death certificate, but there were 21,362 deaths with diabetes listed elsewhere on the certificate. Diabetes was California’s seventh leading cause of death from 2000 through 2008 and the seventh leading cause of death nationally in 2007, the most recent year for which national data is available.
Diabetes primarily affects older people.  Fifty percent of diabetes deaths during this time occurred to people aged 75 and older, and when people aged 65 to 74 were included it rose to over 70 percent.
The chart below shows the age distribution of diabetes deaths for all California residents. Annual age-specific diabetes death rates for the California population are displayed in Table 2a (PDF).
Although diabetes was the seventh leading cause of death for the California population as a whole in 2008, it was the sixth leading cause for males and females when these groups were examined separately. The chart below presents 2000 through 2008 age-adjusted death rates for California residents by sex.
Of California’s 63,440 total diabetes deaths from 2000 through 2008, the proportion was about half between males and females (31,692 deaths in males; 31,748 deaths in females). Refer to Table 4 (PDF), Table 5 (PDF), and Table 6 (PDF) for detailed counts of deaths, age-adjusted rates, and 95 percent confidence intervals by county of residence.  Trend charts showing age-adjusted diabetes death rates by county are accessible through the links provided below.
Of the counties that had reliable rates for every year during the study period, six had statistically significant trends in the diabetes death rate over time.  San Francisco, Shasta, and Ventura counties showed significant decreasing trends, and Kern, Santa Clara, and Solano had significant increasing trends. Twenty-eight counties exhibited rates that were reliable each year but did not show statistically significant trends. See the Technical Notes for information about rate calculation and trend analysis.  A map of California is located here. Finally, because age-adjusted death rates are averages, they represent merely the beginning of an analytical strategy that should proceed to age-specific analyses, and then to an examination of additional sociodemographic, temporal, and geographic variables.
The number of vital events is subject to random variation and a probable range of values can be estimated from the actual figures, according to certain statistical assumptions.
Confidence intervals based on 100 deaths or more – When there were 100 deaths or more, a normal approximation was used to calculate confidence intervals. Confidence intervals based on fewer than 100 deaths – When there were fewer than 100 deaths, a gamma distribution was used to calculate confidence intervals.
Cause of Death – One of the most important uses for vital statistics data is the study of trends by cause of death.

International Classification of Diseases, Tenth Revision (ICD-10) – Beginning in 1999, cause of death has been coded using ICD-10.9  For more information, see the National Center for Health Statistics ICD-10 page. Diabetes mellitus is a complex disease characterized by high levels of sugar (glucose) in the blood. In stressful situations, the body responds by releasing a powerful steroid hormone called cortisol. Cortisol has a specific role in physically preparing the body for any and all situations that are perceived as 'dangerous', whether life-threatening or not.
Interestingly enough, although such stressful situations are distinct, they each elicit similar bodily responses. Long-term exposure to cortisol causes your blood glucose (sugar) levels to rise to the point that insulin (the hormone that lowers blood sugar) is unable to remove it from the bloodstream and into cells. If you are frequently exposed to stress you’re definitely at risk of cortisol-induced type 2 diabetes. Learn healthy lifestyle strategies for reducing your risk of type 2 diabetes and other health problems.
Disclaimer: The information provided is for educational and informational purposes only and is not intended to diagnose, treat, cure or prevent any disease. Your tax-deductible gift today can fund critical diabetes research and support vital diabetes education services that improve the lives of those with diabetes.
Deaths: Diabetes remains the 7th leading cause of death in the United States in 2010, with 69,071 death certificates listing it as the underlying cause of death, and a total of 234,051 death certificates listing diabetes as an underlying or contributing cause of death. About 208,000 Americans under age 20 are estimated to have diagnosed diabetes, approximately 0.25% of that population. In 2008—2009, the annual incidence of diagnosed diabetes in youth was estimated at 18,436 with type 1 diabetes, 5,089 with type 2 diabetes. Diabetes was the seventh leading cause of death in the United States in 2010 based on the 69,071 death certificates in which diabetes was listed as the underlying cause of death.
Hypoglycemia: In 2011, about 282,000 emergency room visits for adults aged 18 years or older had hypoglycemia as the first-listed diagnosis and diabetes as another diagnosis. Kidney Disease: Diabetes was listed as the primary cause of kidney failure in 44% of all new cases in 2011. In 2011, a total of 228,924 people of all ages with kidney failure due to diabetes were living on chronic dialysis or with a kidney transplant.
Amputations: In 2010, about 73,000 non-traumatic lower-limb amputations were performed in adults aged 20 years or older with diagnosed diabetes.
About 60% of non-traumatic lower-limb amputations among people aged 20 years or older occur in people with diagnosed diabetes. After adjusting for population age and sex differences, average medical expenditures among people with diagnosed diabetes were 2.3 times higher than what expenditures would be in the absence of diabetes. These statistics and additional information can be found in the National Diabetes Statistics Report, 2014, the most recent comprehensive assessment of the impact of diabetes in the United States, jointly produced by the CDC, NIH, ADA, and other organizations.
The study, which was conducted by King’s College London and the Universita Cattolica in Rome, Italy, followed 53 diabetic patients between the ages of 30 to 60 with a body-mass index (BMI) of 35 or more for five years.
While the results of this study are optimistic, larger trials are necessary to confirm that surgery is more effective than medication for treating diabetes.

Standard Population, and are summed to produce the age-adjusted rate.  Age-adjusted death rates are highly effective for making comparisons among population groups and among geographical areas because they remove the effects of dissimilar age distributions.
Vital statistics trend research yields valuable information about population health status, emerging public health problems, and at-risk populations, and can be used to develop strategies and allocate resources to improve public health. National Diabetes Fact Sheet: General Information and National Estimates on Diabetes in the United States, 2007. It is a leading cause of death worldwide and most people with the disease have type 2 diabetes. Under normal circumstances, cortisol functions in providing the body with enough energy to cope with day-to-day challenges.
This means that your cortisol levels can become elevated from something as simple as a flight delay to something as life changing as a death in the family.
The primary response that’s linked to the development of type 2 diabetes is related to the specific impact of cortisol on blood sugar levels. Over time, continuous elevations in blood sugar (hyperglycemia) can trigger insulin resistance, a condition in which the body doesn’t properly respond to the blood glucose lowering effects of insulin. This especially holds true for refined "simple" carbs (white bread, packaged cereals, chips, candy, cookies, and soft drinks).
Studies have found that only about 35% to 40% of people with diabetes who died had diabetes listed anywhere on the death certificate and about 10% to 15% had it listed as the underlying cause of death. Now there’s new research to support previous findings that weight loss surgery can be an effective way to treat type 2 diabetes. The researchers found that patients who were treated with weight loss surgery had a lower average level of blood glucose than those who were treated conventionally. Surgery may greatly reduce the need for medication and therefore may be a more cost-effective approach for obese patients. While the development of type 2 diabetes is closely linked to genetic factors, a great deal of evidence suggests that long-term exposure to stress can greatly promote its onset. Adding insult to injury, taking in simple carbs can also trigger elevations in cortisol levels. Stress coping strategies that have been proven effective include weight lifting, cardiovascular (cardio) exercise, and mind-body exercises like yoga, Pilates and Tai Chi.
Your gift today will help us get closer to curing diabetes and better treatments for those living with diabetes. The other 50 percent experienced a relapse of mild hyperglycemia, but showed adequate control of the disease at the five-year mark. Since simple carbs are comprised of sugar, consuming them leads to intense insulin surges followed by marked crashes in blood glucose.
The final section reviews trends in diabetes mortality by county of residence and includes trend charts for each county.
The body treats this response as a 'stressor', which causes substantial rises in cortisol levels.

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