[Course of disease and prognosis of diabetes mellitus]

In potential diabetics, environmental factors, especially overweight, appear to be more significant for the prognosis than genetic factors. The frequency of overt diabetes is higher in females than in males. Mean life expectancy amounts to about 70%, compared with the whole population. Mean survival after manifestation is more than 18 years. Diabetic coma has almost disappeared as cause of death. Today, approximately 75% of diabetics die from vascular complications, mainly from coronary heart disease. The coronaries are affected with same frequency in diabetic males and females. Renovascular complications are the leading cause of death only in young diabetics. Diabetic macro- and microangiopathy is correlated with the duration, not with the severity of diabetes. It should be imperative to physicians to control diabetes very strictly, especially during the first years following manifestation, in order to reduce frequency and/or severity of vascular complications.