A 15-year follow-up study of patients with non-insulin-dependent diabetes mellitus (NIDDM) in Osaka, Japan. Factors predictive of the prognosis of diabetic patients.

Risk factors related to the prognosis of diabetic patients were studied in a follow-up study of 1939 patients with non-insulin-dependent diabetes mellitus (NIDDM) for a mean observation period of 15 years at our institute. Age at entry into the study was the most powerful risk factor related to the survival of diabetic patients in this study. Moreover, the risk of death, computed in relation to baseline factors, was significantly increased in male patients; in patients with fasting plasma glucose (FPG) levels greater than 140 mg/dl, with hypertension, with diabetic retinopathy or with proteinuria; and in patients treated with an oral hypoglycemic agent of insulin at baseline, even after correction for age. The baseline factors were compared between the groups of patients who were alive and who had died at the end of the follow-up study. Greater age at onset of NIDDM and at entry into the study, higher FPG level, higher systolic and diastolic blood pressure, as well as an increase in the proportion of male patients and in patients with ischemic ECG changes, with diabetic retinopathy, with proteinuria, and with treatment with an oral hypoglycemic agent of insulin, were observed in the group of deceased patients. Furthermore, multiple logistic analysis indicated a significant relationship of age at entry, FPG, hypertension, retinopathy, proteinuria and therapeutic regimen to prognosis. We also found that the baseline factors predictive of prognosis were very different in each age group.