Mortality in diabetes mellitus: experience of a geographically defined population.
A population-based cohort study identified 915 deaths in 4186 patients with diabetes mellitus over a 5-year period. Ischaemic heart disease, cerebrovascular disease and malignant neoplasms were the major causes of death and accounted for 40%, 16%, and 14% of deaths, respectively, compared with 27%, 14%, and 25% of deaths in the non-diabetic population. Diabetic patients had a standardized mortality ratio (SMR) of 1.15 (95% Cl 1.08-1.22) (p less than 0.001). This excess risk of death was largely due to the excess death from ischaemic heart disease (SMR 1.55 (1.40-1.71); p less than 0.001) and the impact was greatest in middle-aged female patients. Stroke mortality was not significantly increased (SMR 1.09 (0.92-1.29)) while cancer mortality was reduced (SMR 0.75 (0.63-0.89); p less than 0.01). Death rates in diabetic male patients (SMR 1.04 (0.96-1.13)) did not differ significantly from those in non-diabetic male patients because the increased risk of ischaemic heart disease deaths (SMR 1.41 (1.22-1.62); p less than 0.001) was offset by the reduced risk of deaths from malignant neoplasms (SMR 0.65 (0.51-0.82); p less than 0.001). The reduction in cancer mortality did not reach statistical significance in diabetic women (SMR 0.82 (0.64-1.05)). Diabetic nephropathy and metabolic disasters were uncommon as causes of death.
Wong
J S
JS
Diabetic Clinic, Grampian Health Board, Aberdeen, UK.
Pearson
D W
DW
Murchison
L E
LE
Williams
M J
MJ
Narayan
V
V
D000293:Adolescent; D000328:Adult; D002561:Cerebrovascular Disorders / Q000401:mortality; D002648:Child; D015331:Cohort Studies; D003327:Coronary Disease / Q000401:mortality; D003710:Demography; D003920:Diabetes Mellitus / Q000401:mortality*; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D006113:United Kingdom