Aims/hypothesis: The aim of this study was to examine the mortality rate of subjects with childhood-onset Type I (insulin-dependent) diabetes mellitus in Israel.
Methods: The whole-country cohort of 1,861 children and adolescents (0-17 years) with Type I diabetes, diagnosed between January 1965 and December 1993 in Israel, was analysed for mortality up to October 1996.
Results: A total of 37 deaths were identified with an ascertainment rate of 100%. There was a significant (p < 0.001) excess mortality in the patients with Type I diabetes, the standard mortality ratio being three times higher than that of the general population. The causes of mortality were ketoacidosis (n = 8), infections (n = 8), chronic diabetes complications (n = 9), external causes (n = 6) and other (n = 6). Among the subjects who died, the prevalence of nephropathy, neuropathy and anaemia was higher in female than in male subjects. A total of 17 of the patients with diabetes who died had a central nervous disease (psychosis, mental retardation, epilepsy). There was a trend to lower mortality among the Arab cohort which did not reach statistical significance.
Conclusions/interpretation: Our data provide additional evidence that childhood-onset Type I diabetes carries an increased mortality risk when compared with the mortality risk of the non-diabetic population.