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Causes of death in Japanese patients with diabetes based on the results of a survey of 45,708 cases during 2001–2010: report of Committee on Causes of Death in Diabetes Mellitus

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Abstract

The principal causes of death among 45,708 patients with diabetes (29,801 men and 15,907 women) who died in 241 hospitals throughout Japan during 2001–2010 were determined based on a survey of the hospital records. Autopsy had been conducted in 978 of the 45,708 cases. The most frequent cause of death was malignant neoplasia (38.3%), followed, in order of descending frequency, by infection (17.0%) and then vascular disease (14.9%), including renal failure (3.5%), ischemic heart disease (4.8%) and cerebrovascular disease (6.6%). Diabetic coma associated with hyperglycemia with or without ketoacidosis accounted for only 0.6% of the deaths. In regard to the relationship between the age and cause of death in patients with diabetes, the incidence of death due to vascular diseases was higher in patients over the age of 30 or 40 years, and 97.0% of the deaths due to vascular disease occurred in patients over the age of 50 years. The incidence of death due to infectious diseases, especially pneumonia, increased in an age-dependent fashion, and 80.7% of the deaths due to pneumonia occurred in patients over the age of 70 years. “Poorer” glycemic control was associated with the reduced lifespan of patients with diabetes, especially those with nephropathy. The average age at death in the survey population was 72.6 years. The lifespan was 1.6 years shorter in patients with “poorer” glycemic control than in those with “better” glycemic control. In patients with diabetes of less than 10 years’ duration, the incidence of death due to macroangiopathy was higher than that due to nephropathy. Of the 45,708 patients with diabetes, 33.9% were on oral medication, 41.9% received insulin therapy, and 18.8% were treated by diet alone. Among the patients in whom the cause of death was diabetic nephropathy, a high percentage, 53.7%, were on insulin therapy. The average age at death of the 45,708 patients with diabetes was 71.4 years in men and 75.1 years in women. However, the report of the Ministry of Health and Welfare of Japan in 2010 set the average lifespan of the Japanese at 79.6 years for men and 86.3 years for women. Thus, the average lifespan of patients with diabetes still appears to be shorter than that of the general population in Japan. However, the difference in lifespan between patients with diabetes and the general population is smaller than found in previous surveys.

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References

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Acknowledgements

We would like to thank all the survey participants for their great cooperation in collecting information and completing the questionnaires. We would like to apologize for any trouble this project may have caused to the participants, and we greatly appreciate their valuable contributions. It is entirely due to the assistance of the members of the Japan Diabetes Society, and many non-members as well, that we were able to complete this survey with some degree of success.

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Authors and Affiliations

  1. Division of Diabetes, Department of Internal Medicine, Aichi Medical University, 1-1 Yazako Karimata, Nagakute-Shi, 480-1195, Japan

    Jiro Nakamura & Hideki Kamiya

  2. Division of Metabolism and Biosystemic Science, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan

    Masakazu Haneda

  3. Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Nobuya Inagaki

  4. Division of Endocrinology, Metabolism, Hematological Science and Therapeutics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan

    Yukio Tanizawa

  5. Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan

    Eiichi Araki

  6. Department of Molecular Sciences on Diabetes, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan

    Kohjiro Ueki

  7. Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan

    Takeo Nakayama

Authors
  1. Jiro Nakamura
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  2. Hideki Kamiya
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  3. Masakazu Haneda
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  4. Nobuya Inagaki
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  5. Yukio Tanizawa
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  6. Eiichi Araki
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  7. Kohjiro Ueki
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  8. Takeo Nakayama
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Corresponding author

Correspondence to Jiro Nakamura.

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The authors declare no conflict of interest.

Additional information

In 2011, the Japan Diabetes Society established a Committee on Causes of Death in Diabetes Mellitus, which published its final committee report in 2016 [1]. This is the English version of that report with some revisions, which is published here to enhance our non-Japanese colleagues’ and other interested parties’ understanding of this topic. This is the official published version of that report, which is jointly published in Diabetology International (the official English journal of the Japan Diabetes Society) and the Journal of Diabetes Investigation (the official journal of the Asian Association for the Study of Diabetes: doi:10.1111/jdi.12645).

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Nakamura, J., Kamiya, H., Haneda, M. et al. Causes of death in Japanese patients with diabetes based on the results of a survey of 45,708 cases during 2001–2010: report of Committee on Causes of Death in Diabetes Mellitus. Diabetol Int 8, 117–136 (2017). https://doi.org/10.1007/s13340-017-0313-3

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  • DOI: https://doi.org/10.1007/s13340-017-0313-3

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