title: Trends in the mortality burden associated with diabetes mellitus: a population-based study in Rochester, Minn, 1970-1994.
abstract: BACKGROUND
  The prevalence of diabetes mellitus (DM) has increased markedly in recent decades, but trends in the mortality burden associated with DM are unclear. Therefore, we analyzed population-based longitudinal data to address this issue.
  
  
  METHODS
  The community-based medical records of all Rochester residents 45 years and older who died between January 1, 1970, and December 31, 1994, were reviewed to identify those who met the standardized criteria for DM before death. Trends over successive quinquenniums were assessed for the proportion of all deaths in the community of persons with prevalent DM, for mortality rates for persons with and without DM, and for the distribution of causes of death among decedents with and without DM.
  
  
  RESULTS
  Of 10 152 total deaths in 1970-1994, 1384 (13.6%) met the criteria for prevalent DM. Between 1970-1974 and 1990-1994, the proportion of decedents with DM increased by 48.2%. Mortality rates for persons with and without DM declined by 13.8% and 21.4%, respectively. This disparity in mortality trends was most apparent for older women and younger men. There were temporal declines in the proportion of all persons dying of cardiovascular disease, but temporal declines in persons dying of cerebrovascular disease were found only in decedents without DM.
  
  
  CONCLUSIONS
  The mortality burden associated with DM increased significantly between 1970 and 1994, probably due to increases in DM incidence and smaller declines in mortality for persons with DM relative to those without DM. In the absence of improved DM prevention and treatment, the steady declines in mortality observed for the general population since the 1960s will likely begin to slow or even reverse.
authors.affiliation: Department of Medicine, Mayo Clinic and Foundation, 200 First St SW, Rochester, MN 55905, USA. Thomas.Randal@Mayo.edu
authors.forename: Randal J
authors.initials: RJ
authors.lastname: Thomas
authors.forename: Pasquale J
authors.initials: PJ
authors.lastname: Palumbo
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Melton
authors.forename: Véronique L
authors.initials: VL
authors.lastname: Roger
authors.forename: Jeanine
authors.initials: J
authors.lastname: Ransom
authors.forename: Peter C
authors.initials: PC
authors.lastname: O'Brien
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Leibson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003627:Data Interpretation, Statistical; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009026:Mortality / Q000639:trends*; D015995:Prevalence; D014481:United States / Q000453:epidemiology