A changing pattern of causes of death in Japanese diabetics. Observations over fifteen years

Abstract

Changes in causes of death in Japanese diabetics over the past 15 yr were presented. The subjects studied were 8908 death certificates with mention of diabetes, which were found by the review of some 570,000 certificates reported between 1960–1974 in Osaka, Japan. In 4974 (55.8%), diabetes was identified as the underlying cause and in the remaining 3934 (44.2% ) as a contributory condition. Increase of the deaths from disease of the circulatory system both in contributory and underlying cause was noted. In this category, disease of heart, which was much less frequent than cerebrovascular disease in the period 1960–1964, revealed a rapid increase approaching the level of the latter in underlying cause. However, death due to diseases of the circulatory system were not significantly higher in diabetics than in the general population except the latest period, 1970–1974, indicating that the increase was largely dependent on that in the general population. The outstanding features in comparison of the underlying cause in diabetics between U.S.A. and Osaka were predominance of disease of heart in the former, whereas that of cerebrovascular disease in the latter.