To the Editor: The study of trends in the leading causes of death in the United States by Dr Jemal and colleagues1 reported a 45% increase in the death rate between 1987 and 2002 for those deaths in which diabetes was recorded as an underlying cause. The authors attribute this to an increase in the prevalence of obesity. However, we believe that there are alternative explanations.
Leading Causes of Death in the United States. JAMA. 2006;295(4):383–384. doi:10.1001/jama.295.4.383-a
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