AIMS Although diabetes mellitus at the end of life is associated with complex care, its end-of-life prevalence is uncertain. Our aim is to estimate diabetes prevalence in the end-of-life population, to evaluate which medical register has the largest added value to cause-of-death data in detecting diabetes cases, and to assess the extent to which reporting of diabetes as a cause of death is associated with disease severity. METHODS Our study population consisted of deaths in the Netherlands (2015-2016) included in Nivel Primary Care Database (Nivel-PCD; N = 18,162). The proportion of deaths with diabetes (Type 1 or 2) within the last two years of life was calculated using individually linked cause-of-death, general practice, medication, and hospital discharge data. Severity status of diabetes was defined with dispensed medicines. RESULTS According to all data sources combined, 28.7% of the study population had diabetes at the end of life. The estimated end-of-life prevalence of diabetes was 7.7% using multiple cause-of-death data only. Addition of general practice data increased this estimate the most (19.7%-points). Of the cases added by primary care data, 76.3% had a severe or intermediate status. CONCLUSIONS More than one fourth of the Dutch end-of-life population has diabetes. Cause-of-death data are insufficient to monitor this prevalence, even of severe cases of diabetes, but could be enriched particularly with general practice data.

中文翻译：

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生命终结时的糖尿病患病率：使用单独链接的死亡原因和医疗记录数据进行的调查。

目的尽管糖尿病患者的生命终结与复杂的护理有关，但其生命周期的不确定性仍然不确定。我们的目的是评估临终人口中的糖尿病患病率，评估哪种医疗记录器在检测糖尿病病例中对死因数据具有最大的附加值，并评估将糖尿病报告为死亡的程度。死亡原因与疾病严重程度有关。方法我们的研究人群包括在Nivel初级保健数据库（Nivel-PCD; N = 18,162）中的荷兰（2015-2016年）死亡人数。使用单独关联的死亡原因，一般做法，药物和医院出院数据，计算生命中最后两年内糖尿病（1型或2型）死亡的比例。糖尿病的严重程度由配药定义。结果根据所有数据来源的总和，有28.7％的研究人口在生命终结时患有糖尿病。仅使用多个死亡原因数据，估计糖尿病的生命终结流行率为7.7％。一般实践数据的增加最大程度地增加了这一估计值（19.7％点）。由初级保健数据添加的病例中，有76.3％具有严重或中度状态。结论荷兰超过四分之一的生命终结者患有糖尿病。死亡原因数据不足以监测这种患病率，即使在严重的糖尿病病例中也是如此，但可以通过特别的常规数据加以丰富。一般实践数据的增加最大程度地增加了这一估计值（19.7％点）。由初级保健数据添加的病例中，有76.3％具有严重或中等状态。结论荷兰超过四分之一的生命终结者患有糖尿病。死亡原因数据不足以监测这种患病率，即使在严重的糖尿病病例中也是如此，但可以通过特别的常规数据加以丰富。一般实践数据的增加最大程度地增加了这一估计值（19.7％点）。由初级保健数据添加的病例中，有76.3％具有严重或中等状态。结论荷兰超过四分之一的生命终结者患有糖尿病。死亡原因数据不足以监测这种患病率，即使在严重的糖尿病病例中也是如此，但可以通过特别的常规数据加以丰富。