CHIN-HSIAO TSENG2020-06-012020-06-0119991011-6842https://www.scopus.com/inward/record.uri?eid=2-s2.0-0033377510&partnerID=40&md5=c59f86d7d2100cc12ff247f1bbd5ca33https://scholars.lib.ntu.edu.tw/handle/123456789/496230Diabetes mellitus is the fifth leading cause of death in Taiwan. It is also a major cause of mortality in many other countries. With the discovery of insulin in 1921, mortality from acute complications in diabetic patients decreased abruptly, while cardiovascular mortality increased and replaced acute complications as the most prevalent cause of death. Nowadays, cardiovascular disease accounts for about 75% of total deaths in diabetic patients. Diabetes mellitus confers a 2-4 times higher risk of cardiovascular mortality in patients than in nondiabetic subjects, independent of traditional cardiovascular risk factors such as hypercholesterolemia, smoking and hypertension. Increasing levels of cardiovascular mortality among diabetic patients can be observed in different ethnic groups from either autopsy or epidemiologic studies. The increase of cardiovascular mortality in diabetic patients can result from ineffectiveness of glycemic control in the prevention of macrovascular complications, increasing survival from end-stage renal disease, and the fact that case fatality does not decrease in diabetic patients after onset of myocardial infarction, etc. In spite of the high mortality in diabetic patients, the public health impact of diabetes-related mortality is always underestimated through studies using death certificates. It is strongly advocated that in order to prevent cardiovascular mortality in diabetic patients, active intervention for other traditional cardiovascular risk factors with early detection and treatment is important.Cardiovascular disease; Diabetes mellitus; Diabetic complications; Mortality; Myocardial infarction; Risk factors[SDGs]SDG3cardiovascular disease; cardiovascular risk; cause of death; cigarette smoking; diabetes mellitus; glucose blood level; heart infarction; high risk population; human; hypercholesterolemia; hypertension; life expectancy; mortality; prevalence; review; risk factorreview2-s2.0-0033377510