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Circulation, Vol 82, 37-43, Copyright © 1990 by American Heart Association

ARTICLES

Insulin-dependent diabetes mellitus mortality. The risk of cigarette smoking

CS Moy, RE LaPorte, JS Dorman, TJ Songer, TJ Orchard, LH Kuller, DJ Becker and AL Drash
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.

The relation between cigarette smoking and mortality was examined prospectively in a population of adult insulin-dependent diabetes mellitus (IDDM) patients. In 1981, information on smoking history and other health and lifestyle factors was obtained by questionnaire from 93% of the 723 patients included in the Children's Hospital of Pittsburgh IDDM registry who were diagnosed between 1950 and 1964. Vital status as of January 1, 1988 was ascertained for 98% of the 548 patients who participated in the baseline survey and were alive as of January 1, 1982. Fifty-four cases died during the 6-year follow-up (32 male, 22 female). Proportional hazards analysis revealed that heavy smoking was a significant independent predictor of all-cause mortality among females but not males. The excess mortality in female diabetics was explained primarily by a marked excess risk of coronary heart disease mortality in smokers. These data strongly suggest that cigarette smoking, especially among diabetic females, should be avoided in order to improve longevity.

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