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Excess mortality in Black compared with White patients with Type 1 diabetes: an examination of underlying causes
Author(s) -
Bosnyak Z.,
Nishimura R.,
Hagan Hughes M.,
Tajima N.,
Becker D.,
Tuomilehto J.,
Orchard T. J.
Publication year - 2005
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2005.01671.x
Subject(s) - medicine , hazard ratio , diabetes mellitus , confidence interval , type 2 diabetes , excess mortality , demography , mortality rate , cause of death , negroid , epidemiology , black male , gerontology , pediatrics , disease , endocrinology , sociology , gender studies
Aims Excess mortality in Type 1 diabetes has previously been found among Black individuals. The aim of the present study was therefore to determine underlying causes. Methods A longitudinal study of 1261 [1184 White (93.9%) and 76 Black (6.0%)] individuals diagnosed with Type 1 diabetes between 1965 and 1979, at age < 17 years from the Allegheny County, Pennsylvania and Children's Hospital of Pittsburgh registries. Subjects were contacted in 1999 to determine living status and, where appropriate, cause of death. Living status was determined in 1183 participants (93.8%). Results Of the 200 deaths overall, cause of death was determined in 157 subjects (79%); 31 dying from acute and 101 from chronic complications, and 25 from non‐diabetes related causes. Seven deaths were investigated but no cause determined. Black participants had a significantly higher mortality rate compared with White participants for acute complications (hazard ratio = 4.9, 95% confidence interval: 2.0, 11.6), but not for any other cause. There was a temporal decline in the 20‐year mortality rates in both racial groups across the three cohorts diagnosed in 1965–69, 1970–74 and 1975–79. Conclusions These results show that the excess mortality in Black people was attributed to acute complications which therefore should be a focus for prevention.