No abstract

The centralised registration and care of all diabetics in a geographically defined population has provided an epidemiological basis for a longitudinal investigation of the prognosis of this disease. Records of all newly diagnosed diabetics who had been registered in the Erfurt district (population 1.25 million) in 1966 were studied in relation to the time period 1966-1976. Of the known 2,560 diabetics (910 men, 1,650 women; 93.7% greater than 40 years of age), 1,054 had died during the 10-year follow-up period. Cardiovascular causes accounted for the majority of deaths (63%). In almost all age classes proportionally more men than women had died at follow-up; there was a significant difference in the 60-69 year group (men 61.6%, women 46.2%). In comparison with the general population, excess mortality ranged from 2.1 to 1.0, decreasing with age at onset without significant differences between men and women. Excess mortality was present in most age classes and was evident within the first year after diagnosis. Current life-table analysis confirmed the shortened life expectancy of the diabetics. The lower life expectancy of noninsulin-dependent diabetics may not be due to hyperglycaemia alone but probably also involves a variety of atherongenic risk factors.

No abstract

Generalizations of prognosis with regard to insulin-dependent diabetes (IDDM) in epidemiological statistics are impaired not only by great intraindividual variations, but also due to methodical difficulties. Due to recent prognostic studies IDDM, particular in young age, must be considered as a rather serious disease with a 5 to 10 fold higher excess mortality in comparison with the general population. There are only few exact data about the extent of life shortening. Age of onset represents the most significant factor in life shortening. The younger the patient is at the age of onset the shorter he lives. From about 70 years onward diabetes has little or no effect on longevity. Whether the prognosis of IDDM has improved within the last decades remains uncertain. Long-term studies clearly indicate that IDDM is compatible also with a long life in a good health. Why many diabetics develop life shortening complications and why some patients do not cannot be answered with conclusive evidence.

No abstract