A Further Study on the Causes of Death in Japanese Diabetics

Observations over a 20-Year Period

Abstract

A further study was made on the causes of death in diabetic patients during the 5-year period between 1975-1979 in Osaka, Japan, and the data were analyzed with reference to the previous results for the 15-year period between 1960-1974, as consecutive observations for a 20-year period.
1) The aging of diabetic patients dying during the past 20 years was remarkable: The ratios of those aged 65 years or over was 61% for males and 72% for females.The mean ages at death, which were on a steadily increasing trend as a whole, were exceptionally very low for those who died from tuberculosis and liver cirrhosis and for those who had coma, ketoacidosis or diabetic nephropathy as contributing conditions.
2) Analysis of the underlying causes of death indicated a continuous increase in diseases of the circulatory system, accounting for 50% of the total deaths excluding “diabetes” as the underlying cause. Among the causes, cerebrovascular disease was the greatest in number, but with a gradually declining trend during the latest 5 years.On the other hand, diseases of the heart, which took second place, revealed a rapidly increasing trend, leaving only a small difference from the cerebrovascular disease.An increase in liver cirrhosis was also noted.
3) Diabetic nephropathy, which was described as a contributory condition, also showed an increase, accounting for 18% during the recent 10 years, including renal diseases not defined as diabetic.
It was demonstrated, therefore, that the causes of death among Japanese diabetics had changed considerably during the past 20 years.However, it was also recognized that there was still not a small difference in the distribution from that in Western countries, suggesting some peculiarity in Japanese diabetics as regards their complications and natural history.