Objective: To examine trends in mortality and excess mortality at 5 years among people with diabetes compared to the general population in mainland France during the period 2002–2012. Methods: Two cohorts of adults aged 45 and older, enrolled in the general health insurance system, residing in mainland France and having received at least one reimbursement for oral antidiabetic drugs and/or insulin during the three months preceding the random selection, were formed based on the Entred 2001 and Entred 2007 studies. The follow-up periods were from January 1, 2002, to December 31, 2006, for Entred 2001, and from August 1, 2007, to July 31, 2012, for Entred 2007. A reweighting based on age, sex, and antidiabetic treatment at the start of follow-up was applied to account for missing data due to refusal to participate (respectively <1% and 16% for each of the two cohorts). The analyses were stratified by sex. Medical causes of death were analyzed using the underlying cause and age-standardized mortality rates based on the European standard population (Eurostat). Standardized mortality ratios (SMR) were calculated to compare mortality among people with diabetes to that of the general population. The comparison of mortality rates among people with diabetes between the two follow-up periods was performed using CMF (Comparative Mortality Figure). Results: The analysis included 8,437 individuals from the Entred 2001 cohort (men: 54%; median age as of January 1, 2002: men 65 years and women 70 years) and 5,869 individuals from the Entred 2007 cohort (men: 52%; median age as of August 1, 2007: men 65 years and women 69 years). The age-standardized death rates in the two cohorts were 48.5? and 35.8? for men (CMF=0.74 [0.64–0.85]), and 30.5? and 27.1? for women (CMF=0.89 [0.77–1.02]). Compared to the general population, excess all-cause mortality was high for both men and women with diabetes (for Entred 2007, +34% and +51%, respectively). Excess mortality due to cardiovascular disease decreased from 1.62 [1.43–1.83] to 1.41 [1.20–1.64] for men, though the difference was not statistically significant, and remained stable for women at 1.68 [1.46–1.91] and 1.74 [1.47–2.03] between the two periods. Conclusion: despite a decrease in mortality rates between the two periods, overall excess mortality relative to the general population remains high in the most recent period, among both men and women. Excess mortality from cardiovascular disease remains high among men and particularly among women, among whom it did not decrease between the two periods. These results underscore the importance of measures to prevent cardiovascular complications of diabetes and highlight that further progress is still needed.