Objective To analyze the epidemiologic characteristics and changing trend of mortality of diabetes mellitus in residents in Qinghai province, China, from 1975 to 2020.

Methods The crude mortality, standardized mortality, average annual percentage change (AAPC) and probability of premature death of diabetes mellitus were calculated by region, sex, and age based on the data of causes of death from four retrospective investigations in Qinghai province in 1975, 2006, 2015, and 2020. The chi-square test and t-test were used to compare the rates and AAPC, respectively.

Results From 1975 to 2020, the proportion of deaths from diabetes mellitus in total deaths in Qinghai province increased from 0.10% to 2.55% (AAPC=7.64%, P < 0.05); the crude mortality of diabetes mellitus increased from 0.84/100 000 to 15.66/100 000 (AAPC=6.77%, P < 0.05); the standardized mortality increased from 1.74/100 000 to 20.44/100 000 (AAPC=5.78%, P < 0.05); and the probability of premature death from diabetes mellitus increased from 0.05% to 0.41%. The AAPC values for the component ratio of mortality and standardized mortality in women were 8.28% and 6.01%, respectively, which were significantly higher than 7.10% and 5.62% in men, respectively (P < 0.05). In age distribution, the mortality of diabetes mellitus began to increase from 40-year-olds, and increased with age, peaking over 80-year-olds, except for 1975. In different areas, the standardized mortality of diabetes mellitus also showed an upward trend in general, which was significantly more marked in pastoral areas (from 0.93/100 000 to 16.21/100 000) than in urban and rural areas. The AAPC values in different years for the standardized mortality of diabetes mellitus in urban, rural, and pastoral areas were 4.55%, 5.06%, and 6.86%, respectively.

Conclusion The mortality of diabetes mellitus in Qinghai province is still on the rise, which is more marked in pastoral areas than in urban and rural areas, with a rapid increase in women. It is necessary to implement national health intervention continuously, focus on pastoral areas, rural areas and female residents, and effectively reduce the mortality burden of diabetes mellitus.