Despite the major increase in life expectancy and the development of new technology in diabetes health care, individuals who develop Type 1 diabetes remain at substantially greater risk of early mortality. The acute and chronic complications of diabetes might markedly contribute to this. However, little is known about the underlying cause of this mortality excess, gender and national/ethnic differences and the temporal changes in mortality by the different diabetes complications. Once complication developed, survival pattern becomes important in order to find better approaches to prolong lifetime. This work has been dedicated to evaluate the cause specific mortality pattern of Type 1 diabetes in countries with different health care systems (USA and Cuba) and people with different ethnic background. The presence and effect of major diabetes complications (coronary artery disease and renal disease) were also investigated along with demographic factors and causes influencing survival, also after invasive treatment.