Significance. Diabetes mellitus is a chronic non-infectious disease that develops due to insufficient production of insulin by the pancreas or inefficient use of it by the human body. Who estimates that the number of patients with diabetes has increased 4-fold since 1980 to 422 million in 2014. In 2016, diabetes ranked seventh among the causes of death. Purpose. To study the dynamics and reliability of mortality rates from diabetes, compare it with international data and show the impact on its level of the rules of choosing the initial cause of death. Materials and methods. Statistical reference books of the Ministry of health of the Russian Federation; tables with Rosstat data; standardized mortality rates from the European database "Health for all family", as well as new rules for choosing the underlying cause of death, adopted by who in 2016, were used. Results. The analysis of the total mortality rates from diabetes in the Russian Federation revealed an increase from 9.0 in 2013 to 25.2 in 2017 per 100 thousand population (growth rate of 180.0%). With a tendency to increase the overall mortality rate from diabetes in the Russian Federation and the subjects of the Russian Federation in the Central Federal district, there is a decrease in the mortality rate from myocardial infarctions and acute cerebral circulation disorders. Diabetes was not always chosen as the underlying cause of death, while the mortality rate from diabetes in Russia was underestimated in international comparisons. The first step of the new algorithm for selecting the underlying cause of death does not evaluate the causal relationships between the States listed on the death certificate. Since the adoption of these sequences reflects the interests important to public health, so always follow the instructions regardless of whether it can be considered medically correct or not. Conclusions. Sharp differences in the rate of increase in mortality rates between the regions of the Russian Federation in the Central Federal district (3.3% -1050,0%) indicate non-compliance with the rules of choosing the original cause of death. With an increase in the overall mortality rate from diabetes in 16 of the 18 regions of the Central Federal district, there was a decrease in the mortality rate from acute cerebral circulatory disorders. The use of the new WHO algorithm and adherence to the rules for choosing the underlying cause of death in diabetes will lead to reliable mortality rates from diabetes, comparable to those of other countries.