The incidence of and risk factors for cataract during a mean (standard deviation (SD)) follow-up period of 5.0 (3.0) (range 0.1-12.4) years were examined among 3606 patients (2001 male and 1605 female) with diabetes mellitus from three outpatient clinics at the University Hospital, Nottingham. Among the 3606 patients free of cataract at initial registration who attended the clinic at least twice in the period 1979-1992, the mean (SD) age was 49.2 (17.8) years with a mean (SD) duration of diabetes of 7.6 (9.8) years at initial registration. The incidence of cataract was 10.4 (95% confidence interval (CI), 9.0, 11.9) per 1000 person-years based on 18089 person-years of follow-up. The incidence for females (13.6 (95% CI, 11.0, 16.1)) was greater than in males (8 (95% CI, 6.3, 9. 7)) (P<0.001). The incidence of cataract in insulin-dependent diabetes mellitus (IDDM), non-insulin-treated and insulin-treated non-insulin-dependent diabetes mellitus (NIDDM) were 7.1 (95% CI, 5. 4, 8.9), 11.7 (95% CI, 9.1, 14.3) and 17.8 (95% CI, 12.9, 22.7) per 1000 person-years, respectively. Age-adjustment substantially changed the ordering of risk associated with different types of diabetes. Using a Cox's Proportional Hazards Model for IDDM and NIDDM (insulin and non-insulin-treated) diabetes separately, age and any retinopathy were significant independent predictors of cataract for all groups. Poor metabolic control also was a significant independent predictor of cataract for the IDDM and insulin-treated NIDDM diabetes groups. Duration of diabetes was a significant independent predictor of cataract for the IDDM group. Age at diagnosis of diabetes, systolic and diastolic blood pressure, body mass index, proteinuria, cigarette smoking and creatinine had no significant independent association with cataract when other covariates were considered. These findings will help the identification of those diabetic patients at particular risk of cataract so that clinic time for screening of eyes can be appropriately focused and health care planning for people with diabetes considered.

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The gender differential in mortality from all causes, cardiovascular disease (CVD), ischaemic heart disease (IHD) and stroke during the mean follow-up of 11.6 years (range 10-14) was examined among 4696 men and 5714 women aged 45-64 at entry in West of Scotland. Overall mortality was 19.4/1000 person-years of observation among men and 10.8/1000 person-years among women. A multiple logistic regression model was used to control the influence of gender, along with seven other cardiovascular risk factors simultaneously. The risk factors considered were age, systolic (SBP) and diastolic blood pressure (DBP), serum cholesterol, causal blood glucose, body mass index (BMI) and cigarette smoking. Both the prevalence of risk factors and relative mortality risk associated with them differed by gender. Adjustment slightly reduced the gender differential in overall mortality from 2 to 1.9 and from 1.5 to 1.4 for stroke deaths. Multiple logistic regression increased minimally the gender differential for mortality from 2.4 to 2.8 for CVD and from 2.8 to 3.4 for IHD, suggesting that these cardiovascular risk factors do not account for the overall gender difference in mortality rates. Age, SBP, DBP, blood glucose and cigarette smoking were significant predictors of mortality for both genders. Serum cholesterol was a statistically significant predictor of CVD death only for men.

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These data suggest that the neighbourhood context in which women live has no impact on the risk of GDM. Diabet.