Causes of death in Japanese diabetic patients examined by autopsy

Autopsy records have been published annually by the Japan Society of Pathology. We collected diabetic autopsy cases from these records (1958-1985) and analysed the causes of death. Vascular diseases comprised 38-48% of all causes of death, malignant neoplasms 16-23% and infections 16-23%. Among vascular diseases, the incidence of coronary artery diseases has increased from 6.0 to 17%, but the frequency of nephropathy and cerebrovascular diseases has remained relatively stable since 1970. Diabetic coma and tuberculosis has decreased as a cause of death, while vascular diseases and malignant neoplasm have increased during these periods. These changes reflect the trend of changing disease structure in the general population, which is partly due to the changes in age distribution of the population.