Mortality and causes of death in patients with diabetes mellitus in Japan.

Although the mortality rate of diabetes mellitus in Japan is much lower than the rates in Western countries, an increasing trend has been evident over the last 40 years as a whole. However, the trend shows variations with age; there is an apparent decreasing trend in subjects of 0-35 years of age at death, while there is a remarkable increasing trend in subjects of 75 years of age and over. It appears that the increase in diabetes mortality is largely due to an elevation in the mortality rate in aged subjects and an increase in the size of the aged population in this country. A population-based study of causes of death, carried out in Osaka Prefecture for the period 1960-1989, indicates a remarkable increase in the age at death and significant changes in the causes of death of diabetic patients. Diseases of the circulatory system were found to be the major causes of death other than diabetes, and, among them, a rapid increase in the frequency of disease of the heart was observed. As a cause of death, tuberculosis decreased sharply, while malignant neoplasms, ischemic heart disease, and pneumonia and bronchitis increased during the same period. Among malignant neoplasms, an increase in neoplasm of the liver was marked.