A Twofold Excess Mortality Among Black Compared With White IDDM Patients in Allegheny County, Pennsylvania

Tull, Eugene S.; Barinas, Emma

doi:10.2337/diacare.19.12.1344

Cited by 23 publications

(19 citation statements)

References 9 publications

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“…Greater contact with a diabetes specialist care team has also been suggested to be related to a reduced risk of death in Pittsburgh (18). Another component of the higher mortality in the U.S. is the higher mortality of African-Americans, which has previously been reported as a twofold excess mortality in the same cohort (19). The difference in prognosis after 20 years duration of diabetes was evident.…”

Section: Discussionmentioning

confidence: 73%

Mortality Trends in Type 1 Diabetes

Nishimura

LaPorte²,

Dorman³

et al. 2001

Diabetes Care

140

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OBJECTIVES -To investigate long-term mortality and its temporal trends as of 1 January 1999 among the 1,075 patients with type 1 diabetes (onset age Ͻ18 years, diagnosed between 1965 and 1979) who comprise the Allegheny County population-based registry.RESEARCH DESIGN AND METHODS -Overall, sex-and race-specific mortality rates per person-year of follow-up were determined. Standardized mortality ratios were also calculated. Survival analyses and Cox proportional hazard model were also used. Temporal trends were examined by dividing the cohort into three groups by year of diagnosis (1965-1969, 1970 -1974, and 1975-1979).RESULTS -Living status of 972 cases was ascertained as of January 1, 1999 (ascertainment rate 90.4%). The mean duration of diabetes was 25.2 Ϯ 5.8 (SD) years. Overall, 170 deaths were observed. The crude mortality rate was 627 per 100,000 person-years (95% CI 532-728) and standardized mortality ratio was 519 (440 -602). Life-table analyses by the Kaplan-Meier method indicated cumulative survival rates of 98.0% at 10 years, 92.1% at 20 years, and 79.6% at 30 years duration of diabetes. There was a significant improvement in the survival rate between the cohort diagnosed during 1965-1969 and that diagnosed during 1975-1979 by the log-rank test (P ϭ 0.03). Mortality was higher in African-Americans than in Caucasians, but there were no differences seen by sex. The improvement in recent years was seen in both ethnic groups and sexes.

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Section: Discussionmentioning

confidence: 73%

Mortality Trends in Type 1 Diabetes

Nishimura

LaPorte²,

Dorman³

et al. 2001

Diabetes Care

140

View full text Add to dashboard Cite

show abstract

“…In other autoimmune diseases, such as systemic lupus erythematosus and type 1 diabetes mellitus, significant differences have been identified both in the clinical features and severity of disease between African Americans and whites. [9][10][11][12][13][14][15][16] Analogous data exist for rheumatoid arthritis in which differences in the manifestations of the disease in patients of African American, North Indian, or Pakistani origin compared with whites have been reported. 17 18 To investigate whether such racial differences may also apply in AIH, we have undertaken a systematic review of EC and non-EC patients referred to our outpatient clinics between 1983 and 1999 with respect to their presenting features, response to therapy, and outcome.…”

mentioning

confidence: 77%

Characteristics of autoimmune hepatitis in patients who are not of European Caucasoid ethnic origin

Zolfino

Heneghan²,

Norris³

et al. 2002

Gut

100

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“…This study, in a cohort of minority subjects with childhood-onset diabetes in Chicago, identified increased mortality risk among subjects with postpubertal onset. Previous studies of mortality from childhood-onset diabetes have not distinguished cases with postpubertal onset (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) or type 1 versus type 2 diabetes or have only studied patients presumed to have type 1 diabetes (3,5,6,8,10,14). Authors of one study comparing international death rates asserted that the bulk of the excess mortality should be attributed to type 1 diabetes (9).…”

Section: Methodsmentioning

confidence: 99%

“…Mortality for youth-onset diabetes in Allegheny County, Pennsylvania (9), was found to be 2.5 times higher than in Israel and 1.6 times higher than in Finland, suggesting that some proportion could be preventable. In Allegheny County (13), African Americans died more often from acute complications of diabetes than did whites; Roy et al (14) also found increased mortality among African-American patients with type 1 diabetes in New Jersey. DiLiberti et al (15) used national data to study temporal trends for childhood diabetes mortality.…”

mentioning

confidence: 99%

Risk Factors for Mortality in a Diverse Cohort of Patients With Childhood-Onset Diabetes in Chicago

et al. 2007

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OBJECTIVE—We sought to determine whether risk of death differed by demographic or other characteristics in a population-based cohort of patients with childhood-onset diabetes. RESEARCH DESIGN AND METHODS—The Chicago Childhood Diabetes Registry is an ethnically diverse cohort of patients with diabetes onset between ages 0 and 17 years. Cases that accumulated from 1 January 1985 to 31 December 2000 (n = 1,238) were assessed for vital status using death certificates, family reports, and two large administrative databases (Social Security Death Index and National Death Index). Mortality was compared between subgroups using Poisson and Cox proportional hazards regression. RESULTS—Thirty subjects died, with a mean follow-up time of 7.75 years, yielding a crude case fatality rate of 2.4%. Six subjects died of diabetic ketoacidosis (DKA) at initial presentation. Onset age was the predominant risk factor, driven by a substantially higher fatality rate among those diagnosed at age 17 years (13.36/1,000 person-years) than among other ages and by moderately higher rates for those diagnosed in early adolescence (ages 10–13 years) (3.49/1,000 person-years), compared with children diagnosed before age 10 years (0.89/1,000 person-years) or at ages 14–16 years (0.81/1,000 person-years). Mortality did not differ significantly by other factors examined; data for whites were insufficient to allow comparisons with that group. In addition to diabetes, frequent causes of death were trauma, infectious disease, and cardiovascular disease. CONCLUSIONS— This study provides short- to medium-term follow-up in a diverse cohort of patients. DKA remains a significant cause of death in young people with diabetes. Young people diagnosed at the threshold of adulthood are at increased risk for mortality.

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A Twofold Excess Mortality Among Black Compared With White IDDM Patients in Allegheny County, Pennsylvania

Abstract: The data suggest that some of the excess mortality in black IDDM patients may be preventable.

Cited by 23 publications

References 9 publications

Mortality Trends in Type 1 Diabetes

Mortality Trends in Type 1 Diabetes

Characteristics of autoimmune hepatitis in patients who are not of European Caucasoid ethnic origin

Risk Factors for Mortality in a Diverse Cohort of Patients With Childhood-Onset Diabetes in Chicago

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