Diabetes Care, Vol 19, Issue 12 1344-1347, Copyright © 1996 by American Diabetes Association
A twofold excess mortality among black compared with white IDDM patients in Allegheny county, Pennsylvania. Pittsburgh DERI Mortality Study Group
ES Tull and E Barinas
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA. est@vms.cis.pitt.edu
OBJECTIVE: To examine the long-term mortality experience of blacks who
develop IDDM in childhood. RESEARCH DESIGN AND METHODS: The 11-25-year
mortality status of individuals with IDDM who participated in the Diabetes
Epidemiology Research International (DERI) Mortality Study was verified as
of 1 January 1990 for 1,008 (94%) of the 1,076 individuals in the study.
Life-table analysis was performed, and race-specific rates were determined
for the final sample. RESULTS: Among black patients, 14.9% died compared
with 6.6% of the white patients after a maximum of 25 years of follow-up.
African-Americans experienced an age-adjusted mortality rate that was over
twice that of whites for the entire period (9.4 vs. 3.8 per 1,000
person-years, respectively; P < 0.05) and at each 5-year interval of
follow-up. Among blacks, the mortality rate for females (15.9/1,000
person-years) was 8.4 times (P < 0.05) that of males (1.9/1,000
person-years). In contrast, this sex difference was not seen among whites.
Acute complications of diabetes accounted for 40% of the mortality in the
black patients, while only 23% of the white patients died from acute
causes. CONCLUSIONS: The data suggest that some of the excess mortality in
black IDDM patients may be preventable.