The risk of mortality among people with type 2 diabetes in Latin America: A systematic review and meta‐analysis of population‐based cohort studies

Summary Type 2 diabetes mellitus (T2DM) is associated with a high mortality risk, although the magnitude of this association remains unknown in Latin America (LA). We aimed to assess the strength of the association between T2DM and all‐cause and cause‐specific mortality in population‐based cohort studies in LA. Systematic review and meta‐analysis: inclusion criteria were (1) men and women 18 years old and above with T2DM; (2) study outcomes all‐cause and/or cause‐specific mortality; and (3) using people without T2DM as comparison group. Five databases (Scopus, Medline, Embase, Global Health, and LILACS) were searched. Risk of bias was evaluated with the ROBINS‐I criteria. Initially, there were 979 identified studies, of which 17 were selected for qualitative synthesis; 14 were included in the meta‐analysis ( N = 416 821). Self‐reported T2DM showed a pooled relative risk (RR) of 2.49 for all‐causes mortality (I‐squared [I 2 ] = 85.7%, p < 0.001; 95% confidence interval [CI], 1.96‐3.15). T2DM based on a composite definition was associated with a 2.26‐fold higher all‐cause mortality (I 2 = 93.9%, p < 0.001; 95% CI, 1.36‐3.74). The pooled risk estimates were similar between men and women, although higher at younger ages. The pooled RR for cardiovascular mortality was 2.76 (I 2 = 59.2%; p < 0.061; 95% CI, 1.99‐3.82) and for renal mortality 15.85 (I 2 = 0.00%; p < 0.645; 95% CI, 9.82‐25.57). Using available population‐based cohort studies, this work has identified and estimated the strength of the association between T2DM and mortality in LA. The higher mortality risk compared with high‐income countries deserves close attention from health policies makers and clinicians to improve diabetes care and control hence preventing complications and delaying death.