Abstract Aims/Introduction The increased mortality risk associated with diabetes is well established. The aim of the present study was to determine the causes of death of people with type 2 diabetes in Ayrshire and Arran, Scotland, between 2009 and 2014, and compare them with the national mortality rates. Materials and Methods The primary causes of death were collated. The causes of death were clustered into nine categories: heart disease, stroke, infection, renal failure, respiratory disorders, cancer, mental health, decompensated diabetes and other. The total rates were compared with national rates using the standardized mortality ratio (SMR), and then individually with heart disease, cerebrovascular disease and cancer. Results There were 2116 deaths with the SMR, and 145 of those were caused by type 2 diabetes (n = 16,643; 95% confidence interval 139–152; P 100 in all age bands, particularly in the younger age bands (P 100 for both sexes in all age bands