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8 1) University Group Diabetes Program: A study of hypoglycemic agents on vascular complica- in patients with adult-onset tions diabetes. I. Design, methods and baseline results. Diabetes 19 (suppl. 2): 747, ) University Group Diabetes Program: A study of the results of hypoglycemic agents on vascular complications in patients with adult-onset diabetes. II. Mortality results. Diabetes 19 (suppl. 2): 789, ) University Group Diabetes Program: Effects of hypoglycemic agents on vascular complications in patients with adult-onset diabetes. III. Cli- implications of UGDP results. J. Amer. nical Med. Ass. 218: 1400, ) University Group Diabetes Program: Effects of hypoglycemic agents on vascular complications in patients with adult-onset diabetes. IV. A preliminary report on phenformin results. J. Amer. Med. Ass. 217: 777, ) Kessler, I. I.: Mortality experience of diabetic patients. A twenty-six year follow-up study. Amer. J. Med. 51: 715, ) Seltzer, H. S.: Avoiding the pitfalls of long-term therapeutic trials: Lessons learned from the UGDP study. J. Clin. Pharm. 12: 393, ) Hadden, D. R., Montgomery, D. A. D. and Weaver, J. A.: Myocardial infarction in maturity-onset diabetics. A retrospective study. Lan- cet 1: 335, ) Boyle, D., Bhatia, S. K., Hadden, D. R., Montgomery, D. A. D. and Weaver, J. A.: Ischemic heart-disease in diabetics. A prospective study. Lancet 1: 338, 1972.

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10 Abstract Statistical Studies of 1,885 Death Cases of Diabetes in Japan The Relation between Causes of Death and Therapeutic Methods of Diabetes Yukimasa Hirata*, Toshihiko Mihara*, Katsushi Sakasegawa*, Yoshihiro Ando*, Hiromi Nishimura*, Masanobu Mori*, Tadasu Kasahara*, Kunio Nagaoka*, Masato Tominaga*, Akira Takeda* and Takayoshi Toyota** *The First Department of Internal Medicine, Tottori University School of Medicine, Yanago. **The Third Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki. A retrospective study of causes of death in 1,885 diabetic patients treated in 384 hospitals and died during in Japan is reported. Significant differences of death causes were observed between the groups of the patients divided by the duration of diabetes (under 5 years or over 5 years), also among the groups divided by therapeutic methods of diabetes (diet alone, oral hypoglycemic agents or insulin). Concerning angiopathies, the incidence of deaths due to nephropathy and ischemic heart disease (IHD) was higher in the group of patients suffering from diabetes over 5 years. An incidence of cerebrovascular disease as a cause of death was not so different between the two groups divided by the duration of 5 years. A significant difference in the cause of death was also shown among the groups treated with diet only, oral hypoglycemic agents or insulin. The principal causes of death were diabetic coma and diabetic nephropathy for the insulin-treated group, cerebrovascular disease and IHD for the tablet-treated group, and malignant neoplasms for the diet-treated group. In particular, it was noteworthy in this study that an incidence of death cases due to IHD was significantly higher in the tablet-treated group compaired with other groups. However, this phenomenon trended already within 3 years after the initiation of the drug therapy. Therefore there would be an apparent association between IHD and oral hypoglycemic therapy.

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