Five-year incidence of major macrovascular complications in diabetes mellitus.

The incidence of macrovascular morbidity and mortality in diabetics is high. At the end of a five-year observation period in the Schwabing Study 138 (26.5%) out of 542 reexamined diabetics suffered from a cardiovascular death, gangrene or myocardial infarction. Univariate and multiple logistic analysis revealed age, systolic blood pressure, and serum triglycerides as significant predictors. Duration of diabetes was only significant in type I-diabetics. Sex differences exist. In conclusion, a basis for preventive measures of major macrovascular complications in diabetes is given. Atherosclerosis represents the major cause of morbidity and mortality in the diabetic patient. Particularly overt and borderline diabetics are afflicted who constitute 10-15% of the population in the western industrial countries. Due to high incidence and rapid progression of atherosclerosis in diabetes mellitus cardiovascular diseases and their causes can be studied in these patients at best. An excess morbidity in diabetics due to cardiovascular disease has been noted in several epidemiologic studies, although the number of patients are rather small in some studies. In the Bedford Study, for instance, 111 overt diabetics, in the Framingham Study less than 250 diabetic were included. Furthermore, subjects were examined at a relatively young age (35-55 years) where only a low incidence of vascular diseases at diagnosed by noninvasive methods can be expected. Accordingly, inconsistant data have been obtained. The Schwabing Study for Macrovascular Disease in Diabetes Mellitus is a longitudinal study of more than 600 diabetic outpatients by all ages. The results of 5-year incidence of major macrovascular complications and its relationship to a number of cardiovascular risk factors will be given in this communication.