MORTALITY IN DIABETIC SUBJECTS - AN 11-YEAR FOLLOW-UP OF A COMMUNITY-BASED POPULATION

In 1979, all the known diabetic subjects (849) were identified from a community (population 81851), of whom 717 (85 %) were reviewed by a si ngle observer. Using the NHS Central Register, follow-up was completed for 98 % of subjects. After 11 years, 306 (42.7 %) diabetic subjects had died, of whom 65 were insulin treated and 241 were noninsulin trea ted. Circulatory disease accounted for 168 (54.9 %) deaths, of which 1 24 (73.8 %) were due to ischaemic heart disease. The standardized mort ality ratio (SMR) for all causes of death, based on data from England and Wales, was significantly raised for both insulin-treated and non-i nsulin-treated patients (1.75, 95 % CI 1.35 to 2.24 and 1.32, 95 % CI 1.15 to 1.50, respectively). SMRs for all cause mortality were signifi cantly greater for diabetic subjects in the 45-64 (SMR, 1.97, 95 % CI 1.34 to 2.80), 65-74 (SMR 1.59, 95 % CI 1.27 to 1.97 and 75 years and over (SMR 1.26, 95 % CI 1.08 to 1.45) age ranges. Using a proportional hazards model, after adjusting for age and gender, systolic blood pre ssure and vibration threshold were significant predictors of all cause mortality in insulin-treated subjects. For non-insulin-treated subjec ts, blood glucose, systolic blood pressure, glycated haemoglobin, reti nopathy, proteinuria, coronary artery disease, and stroke were signifi cant baseline predictors of mortality. No association was found for se rum cholesterol, body mass index, diastolic pressure or cigarette smok ing in either treatment group.