Mortality in a large population-based cohort of patients with drug-treated diabetes mellitus

Objectives. This paper presents detailed cause-specific data about excess mortality among diabetic persons in Finland, by age and sex. Methods. Five-year follow-up data on the Finnish population aged 30 through 74 years were analyzed. During these 5 years, 11215 persons with diabetes and 102843 persons without diabetes died. The diabetic population was defined as people who were entitled to free medication for diabetes at the beginning of the follow-up period, that is, at the end of 1980. Results. The relative mortality of persons with drug-treated diabetes compared with nondiabetic persons was higher among women (3.4) than among men (2.4). Almost three quarters of the mortality excess was due to circulatory diseases. For most other causes of death, too, diabetic persons had higher than average mortality. The exceptions were lung cancer, chronic obstructive pulmonary disease, and alcohol poisoning. Conclusions. Diabetes is a general risk factor for untimely death and makes a significant contribution to overall national death rates, particularly for circulatory diseases. Lower than average mortality from smoking-related diseases and alcohol poisoning, however, warrant optimism about the effects of health education among diabetic persons.