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Aims To measure cause‐specific mortality, by age, in patients with insulin‐treated diabetes incident at a young age.

Methods A cohort of 23 752 patients with insulin‐treated diabetes diagnosed under the age of 30 years, from throughout the United Kingdom, was identified during 1972–93 and followed to February 1997. Death certificates have been obtained for deaths during the follow‐up period and cause‐specific mortality rates and standardized mortality ratios by age and sex are reported.

Results During the follow‐up period 949 deaths occurred and at all ages mortality rates were considerably higher than in the general population. Acute metabolic complications of diabetes were the greatest single cause of excess death under the age of 30 years. Cardiovascular disease was responsible for the greatest proportion of the deaths from the age of 30 years onwards.

Conclusions Deaths in patients with …