Diabetes increases mortality, with this excess mainly being attributable to cardiovascular disease (CVD). However, patterns of mortality may be changing. Marked declines in mortality among the general population, primarily from CVD, have been noted in the past decades, with some evidence that mortality in type 2 diabetes may be approaching that of the general population. On the contrary, there is increasing concern about the role of diabetes as a risk factor for certain types of cancers, such as pancreas, liver, and colon, rectum, and for cancer mortality in several populations. Compared to western countries, the proportion of people with diabetes has dramatically increased throughout Asia. People in Asia tend to develop diabetes with a lesser degree of obesity at a younger age, suffer more from complications diabetes, and die sooner than people in other regions. On behalf of the Committee on the Epidemiology of Diabetes Mellitus in KDA, we had analyzed the mortality data from the three pooled community-based cohort study. They showed that diabetes was associated with higher risk of death from all causes and cancer. I will talk about the extension analysis of this pooled studies, and other epidemiologic evidences to show the trends of mortality and causes of death in patients with diabetes in Korea.