A community study of diabetes in a population with a high diabetes mortality rate.

Among the 47 prefectures of Japan, the prefecture of Shiga stands out due to its remarkably high death rate from diabetes, especially in female diabetics. In an attempt to clarify the causes, a diabetes detection study was carried out in the inhabitants aged 40 or over of five communities. The prevalence rate of diabetes was 1.7%; male 2.5% and female 1.3%. However, the study could include only 14% of the inhabitants (3253 out of 23,249 inhabitants). In a community named Aito, where the diabetic death rate was the highest among communities of the prefecture and the study covered 95% of the 1849 inhabitants, the prevalence of diabetes was 3.0% in males and 1.2% in females (2.2% in total). Obesity, hypertension and ischemic change in electrocardiogram were more frequent in female diabetics than in male diabetics in this community. These results suggest that the high death rate from diabetes in the female population is not caused by a high prevalence rate of diabetes and female diabetics may be affected by several risk factors which influence their prognosis more often than that of male diabetics.