A retrospective analysis of a cohort of 5210 diabetic patients revealed a mortality rate 1.3 times higher than in the general population of Warsaw. The higher death rate in the cohort under study was mainly due to an excess mortality from coronary heart disease and cerebrovascular disease. The excess mortality was greater in men than in women. Th risk of death from cardiovascular diseases was higher among the patients with early onset diabetes. Mortality from cerebrovascular disease was highest in patients treated with insulin, intermediate in the group treated with oral drugs, and lowest in the group treated only with diet. The mortality ratio from coronary heart disease in men was not related to the method of hypoglycaemic therapy given at the onset or during the course of the diabetes. In women, the highest mortality was in the group treated with insulin, intermediate in the group treated with oral agents, and lowest in the group treated with diet only.

The clinical course of myocardial infarction (MI) was compared between 154 known diabetic (Ds) and nondiabetic (NDs) MI patients matched for age, sex, and hospital ward. In both groups similar numbers of cases with cardiac rupture, shock, pulmonary edema, and clinically observed arrhythmias were found. In contrast, Ds patients had significantly more frequent A-V and intraventricular conduction disorders than NDs (P less than 0.02). Ds also died twice more often from MI (36%) than matched controls (18%). The excess case fatality rates from MI among Ds were limited to the period between the second and seventh day of hospitalization. The excessive fatality of Ds from MI resulted mainly from the high liability of insulin-dependent diabetic patients (IDDs), with the relative risk of over 4 in relation to NDs. Ds with arrhythmias and/or conduction disorders had a particularly poor prognosis for surviving, the relative risk exceeding 3. No ready explanation of this phenomenon is presently available.

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