Objective: To examine 10-year excess mortality—both overall and by specific causes—in a cohort of people with diabetes (Entred 2001) compared with the general population during the period 2002–2011. Methods: The study population consisted of adults aged 45 and older enrolled in the general health insurance system residing in metropolitan France who had received at least one reimbursement for oral antidiabetic medications and/or insulin during the three months preceding the random selection. Medical causes of death were analyzed as the underlying cause over the period from January 1, 2002, to December 31, 2011. Standardized mortality ratios (SMR) were calculated to compare mortality in the diabetic population with that of the general population. Results: The analysis included 8,437 individuals from the Entred 2001 cohort (men: 54%; median age at enrollment: 65 years for men and 70 years for women). During the 10-year follow-up period, 35% of the individuals died. The median age at death was 77 years for men (n=1,686 deaths) and 82 years for women (n=1,290). The leading causes of death were cardiovascular disease (30%) and cancer (26%). The overall excess mortality among people with diabetes compared to the general population was high for men (1.55, 95% CI: [1.48–1.63]) and women (1.63 [1.54–1.72]). Both men and women with diabetes had significantly higher excess mortality compared to the general population for cardiovascular and renal diseases, as well as for certain cancer sites: pancreas, liver, and colorectal. Among women, excess mortality was observed for uterine cancer, and among men for bladder cancer and leukemia. Additionally, excess mortality was found for diseases of the digestive system, infectious diseases, and respiratory diseases, including pneumonia. Conclusion: This study once again highlights the importance of strengthening prevention and improving the quality of care for degenerative complications of diabetes. It also underscores the burden of multimorbidity (primarily cancers, but also infectious diseases, digestive system diseases, liver diseases, etc.) and the complexity this introduces in the management of people with diabetes.