FACTORS CONTRIBUTING TO DEATHS OF DIABETICS UNDER FIFTY YEARS OF AGE

Factors contributing to the deaths of 448 diabetics under the age of fifty years who died in the United Kingdom in 1979 are examined. Two- thirds died during the fifth decade of life. The major causes of death were myocardial infarction and other large vessel disease (41%), diabetic renal disease (19%), and diabetic ketoacidosis (15%). Hypoglycaemia caused 4% of deaths and the remaining 21% died from primarily non-diabetic causes. Deaths from myocardial infarction were unrelated to the duration of diabetes and were twice as common in men as in women, while associated factors included peripheral vascular disease, hypertension, smoking, and obesity. Diabetic renal disease was related to the duration of diabetes and other evidence of microvascular disease. Most of the renal deaths were regarded as inevitable, but early consideration of transplantation is needed. Diabetic ketoacidosis was the commonest cause of death below the age of twenty years and occurred in 27 people previously unrecognised as diabetic. Delays in seeking and providing medical attention were major contributory factors to those deaths.