Impact of the increasing burden of diabetes on acute myocardial infarction in New York City: 1990-2000.

Worldwide increases in obesity and diabetes have aroused concern that increased morbidity and mortality will follow. The objective here is to determine the trend of diabetes-related morbidity and mortality in New York, New York. Using New York death certificate data for 1989-1991 and 1999-2001 and hospital discharge data for 1988-2002, we measured all-cause and cause-specific mortality in 1990 and 2000, as well as annual hospitalization rates for diabetes and its complications among patients hospitalized with acute myocardial infarction and/or diabetes. During this decade, all-cause and cause-specific mortality rates declined, with the striking exception of diabetes, which increased 61 and 52% for men and women, respectively, as did hospitalization rates for diabetes and its complications. The percentage of all acute myocardial infarctions occurring in patients with diabetes increased from 21 to 36%, and the absolute number doubled from 2,951 to 6,048. Although hospital days due to acute myocardial infarction fell overall, for those with diabetes, they increased 51% (from 34,188 to 51,566). These data document a marked upsurge in diabetes-related mortality and morbidity in New York City, including a sharp increase in diabetic patients hospitalized for myocardial infarction. If continued, this threatens the long-established nationwide trend to reduced coronary artery disease events.