Abstract
A total of 23, 577 death certificates mentioning diabetes, 10, 927 as the underlying cause and 12, 650 as a contributory condition, which were filed in Osaka, Japan, during a 25-year period between 1960 and 1984, were analyzed, using the multiple coding method.
1) The ratio of death certificates mentioning diabetes, which was only 0.9% of all causes of death in 1960-1964, rapidly increased to 3.5% in 1980-1984. Among diabetics, the ratio of patients aged 65-years or over increased markedly duing the same period, from 47.2% to 68.8%.
2) On the other hand, the ratio of diabetes as the underlying cause among certificates mentioning diabetes decreased drastically, from 57.7% in 1960-1964 to 36.8% in 1980-1984.
3) Remarkable changes in the underlying causes of death among diabetics were observed during the study period: an increase in disease of the circulatory system, especially heart disease, which exceeded cerebrovascular disease in 1980-1984.
4) An increase in diabetic nephropathy, which had not been analyzed previously since it was reported as a contributory condition, was also confirmed using the multiple coding method employed here.
