There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
We aimed to examine the mortality rates, excess mortality and causes of death in diabetic
patients from ten centres throughout the world.
A mortality follow-up of 4713 WHO Multinational Study of Vascular Disease in Diabetes
(WHO MSVDD) participants from ten centres was carried out, causes of death were ascertained
and age-adjusted mortality rates were calculated by centre, sex and type of diabetes.
Excess mortality, compared with the background population, was assessed in terms of
standardised mortality ratios (SMRs) for each of the 10 cohorts.
Cardiovascular disease was the most common underlying cause of death, accounting for
44 % of deaths in Type I (insulin-dependent) diabetes mellitus and 52 % of deaths
in Type II (non-insulin-dependent) diabetes mellitus. Renal disease accounted for
21% of deaths in Type I diabetes and 11% in Type II diabetes. For Type I diabetes,
all-cause mortality rates were highest in Berlin men and Warsaw women, and lowest
in London men and Zagreb women. For Type II diabetes, rates were highest in Warsaw
men and Oklahoma women and lowest in Tokyo men and women. Age adjusted mortality rates
and SMRs were generally higher in patients with Type I diabetes compared with those
with Type II diabetes. Men and women in the Tokyo cohort had a very low excess mortality
when compared with the background population.
This study confirms the importance of cardiovascular disease as the major cause of
death in people with both types of diabetes. The low excess mortality in the Japanese
cohort could have implications for the possible reduction of the burden of mortality
associated with diabetes in other parts of the world.