{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T14:04:38Z","timestamp":1768572278513,"version":"3.49.0"},"posted":{"date-parts":[[2025,11,30]]},"group-title":"Endocrinology (including Diabetes Mellitus and Metabolic Disease)","reference-count":17,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T00:00:00Z","timestamp":1764460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,11,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study aims to analyze the trend in the mortality rate due to Diabetes Mellitus among older adults in Brazil between 2012 and 2022.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>An ecological study was conducted using secondary, publicly available data on deaths from DM (ICD-10 codes E10\u2013E14) obtained from the Departamento de Inform\u00e1tica do Sistema \u00danico de Sa\u00fade (DATASUS). Standardized mortality rates were calculated based on the world standard population proposed by Segi (1960) and modified by Doll et al. (1966). Temporal trends were analyzed using the Prais-Winsten regression model, which corrects for first-order autocorrelation in time series. The Moran Global Index and Local Indicators of Spatial Association (LISA) were applied to assess spatial dependence and to identify high- and low-risk clusters across Brazilian regions.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Between 2012 and 2022, Brazil recorded a total of [inserir n\u00famero] deaths from DM among older adults. The standardized national mortality rate showed a decreasing trend during the period; however, regional disparities were evident. The North and Northeast regions presented higher and more persistent rates compared to the South and Southeast, which showed a more consistent decline. Spatial analysis revealed significant positive spatial autocorrelation (Moran\u2019s I = [valor]; p &lt; 0.05), identifying clusters of high mortality in municipalities of the Northeast and North regions.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The spatial and temporal analyses highlighted persistent regional inequalities in mortality due to DM in Brazil. While national mortality has declined, the concentration of high-risk clusters in socioeconomically vulnerable areas suggests that health interventions and policies must prioritize these regions. Understanding the spatial-temporal distribution of DM mortality contributes to more equitable public health planning, reinforcing the importance of targeted actions in prevention, early diagnosis, and access to continuous care for chronic conditions.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.11.26.25341115","type":"posted-content","created":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T21:55:11Z","timestamp":1764539711000},"source":"Crossref","is-referenced-by-count":0,"title":["Diabetes mellitus mortality among elderly Brazilians, 2012-2022: an ecologic study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6103-0842","authenticated-orcid":false,"given":"Luciana Lima","family":"de Ara\u00fajo","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8673-0009","authenticated-orcid":false,"given":"Thaiza Teixeira Xavier","family":"Nobre","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5578-5413","authenticated-orcid":false,"given":"Maria Eduarda Silva","family":"do Nascimento","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2646-2863","authenticated-orcid":false,"given":"Lidiany Galdino","family":"Felix","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6290-9365","authenticated-orcid":false,"given":"Richardson Augusto","family":"Rosendo","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0304-2639","authenticated-orcid":false,"given":"Ketyllem Tayanne da Silva","family":"Costa","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2654-0497","authenticated-orcid":false,"given":"Clemente Neves","family":"Sousa","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9015-211X","authenticated-orcid":false,"given":"Ana Elza Oliveira","family":"de Mendon\u00e7a","sequence":"additional","affiliation":[]}],"member":"54368","reference":[{"issue":"12","key":"2025120123252019000_2025.11.26.25341115v1.1","first-page":"e20230408","article-title":"The Six Pillars of Lifestyle Medicine in Managing Noncommunicable Diseases \u2013 The Gaps in Current Guidelines","volume":"120","year":"2023","journal-title":"Arq Bras Cardiol"},{"key":"2025120123252019000_2025.11.26.25341115v1.2","doi-asserted-by":"crossref","first-page":"e3971","DOI":"10.1590\/1518-8345.6592.3972","article-title":"Relationship between social development indicators and mortality due to Diabetes Mellitus in Brazil: a space-time analysis","volume":"31","year":"2023","journal-title":"Rev Latino-Am Enfermagem"},{"issue":"1","key":"2025120123252019000_2025.11.26.25341115v1.3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1590\/1806-9282.65.1.3","article-title":"Prevalence, treatment, and control of dyslipidemia in diabetic participants of two Brazilian cohorts: a place far from heaven","volume":"65","year":"2019","journal-title":"Rev Assoc Med Bras"},{"key":"2025120123252019000_2025.11.26.25341115v1.4","unstructured":"Minist\u00e9rio da Sa\u00fade (BR ). Conselho Nacional de Sa\u00fade. Resolu\u00e7\u00e3o n\u00b0 466, de 12 de dezembro de 2012. Aprova diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Bras\u00edlia: Minist\u00e9rio da Sa\u00fade, 2012. Available from: https:\/\/bvsms.saude.gov.br\/bvs\/saudelegis\/cns\/2013\/res0466_12_12_2012.html. 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