Diabetic mortality in Edinburgh.

A prospective study of mortality in 3,113 diabetics was carried out in Edinburgh over a period of eight years; 1,272 patients (41 %) died. Death rates for females equalled those for males and, in relation to the general population, there was a considerable excess mortality which was greater for females. Statistical analysis indicated that the important mortality risk-factors are age, duration of diabetes of greater than ten years and treatment. The risk of oral therapy or insulin were approximately equally greater than that of diet therapy and probably reflected severity of disease. Using international coding for diagnosis, 27 % of deaths were classified as directly due to diabetes and 49 % to vascular disease. Reclassifying the terminal cause of death left only 26 patients (2 %) recorded with diabetes as the direct cause of death. Three hundred and thirty five males (66 %) and 561 females (73 %) died of vascular disease. There was a predominance of myocardial infarction in males and cerebrovascular disease in females. These percentages were a little lower when post-mortem information was available. These results provide additional evidence that diabetes reduces life expectancy by inducing premature vascular disease and that the effect is greater in women than in men.