MORTALITY RELATED TO DIABETES AND BLOOD GLUCOSE LEVELS IN A COMMUNITY STUDY

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Abstract
A prospective 29year population study of diabetes in Oxford, MA, is the basls for a casecontrol analysis of diabetes mortallty rates and their validity. Two case groups were considered, one consisting of previously known diabetics at the study's inception in 1946 and the other defined by hypergiycemia above 140 mg/di. Mortality rates were significantly higher for diabetics than for age- and sex-matched controls, and disproportionately higher for women largely due to the advantageous mortality experience of nondiabetlc women compared to nondiabetlc men. Estimated survlvai experience showed iongev- Ity to be shorter by some 10 to 15 years for the female and six to nine years tor the male diabetic. Mortallty rates were also slgnlficantly higher for the hyperglycemic group than for matched controls. Aithough deaths from cardlovascuiar causes were predominant, they proved significantly higher for women with known diabetes only. Substantlai underreporting of diabetes on the death certificates persisted in every decade of the study. The proportion of prevaient and incident cases of diabetes during the 29-year perlod of the study, whose diagnosls falied to appear anywhere on the death certificate, was found to be at or above 50%. Among subjects with death certificates that did not list diabetes, 4.4 to 14.1% were known to have diabetes, based on the underlying composition of the sample. Prevalent cases of diabetes had a higher reporting rate than incident cases, suggesting that duration of diabetes may also be a factor in such rates.