The natural history of diabetes: Factors present at time of diagnosis which may be predictive of length of survival

Factors present at the time of diagnosis in a group of 294 patients, who have been matched for sex, and age at diagnosis, (30–49 yr—153 cases; 50–69 yr—141 cases) have been analyzed in terms of their association with length of survival, (0–9, 10–19 and 20 yr and longer) after diagnosis of diabetes mellitus. The presence of an elevated blood pressure, evidence of cardiovascular disease, (particularly in the 30–49 yr of age group at diagnosis) or albuminuria at the time of diagnosis of diabetes are associated with decreased longevity. Longer survival is noted when blood glucose appears to be better controlled and no insulin is required for treatment. However, this group may represent individuals who are detected in an earlier stage of the disease and, therefore, may show only an apparently greater longevity following diagnosis. When insulin is required, reported occurrence of insulin reaction is associated with longer survival. Having a diabetic father or having the symptom of pruritus vulvae at diagnosis seems to favor longer survival.