This is a prospective study designed to further define the prevalence, incidence, morbidity and mortality of non-insulin dependent (Type II) diabetes mellitus and of fasting hyperglycemia in a previously characterized adult community. In 1972-74, 82 percent of a geographically defined population (n=4382) aged 40-79 participated in a heart disease risk factor survey that included a medical and cigarette smoking history and measurements of height, weight, blood pressure, cholesterol, triglyceride and fasting plasma glucose (FPG). In 1974-76, approximately one-third of this cohort (n=1403) was examined more extensively, including repeat mesurements of FPG, lipids and lipoproteins, medication, alcohol and cigarette use, resting and exercise ECG and 24-hour diet recall. Approximately half of this subset (n=624) had a third visit in 1978-79 which included all of the above biochemical and behavioral assessments, glycosylated hemoglobin, self-reported particulars related to the diagnosis, duration and severity of diabetes, and four non-invasive tests for peripheral arterial disease. The entire cohort has been followed for mortality to the present, with 99 percent ascertainment in this, the 8th followup year. We propose to a) validate and characterize the diagnosis of diabetes in all members of the original cohort who then or subsequently identified themselves as diabetic, b) reexamine 3000 surviving members of this cohort an average of 10 years after the first visit in order to obtain data on diabetes incidence and cardiovascular, retinal and renal morbidity, and c) extend the mortality followup an additional five years in order to examine 15-year all-cause and cardiovascular mortality as related to diabetes and to borderline fasting hyperglycemia after adjusting for the effect of previously measured covariates.
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