Demographic Correlates of Short-Term Mortality Among Youth and Young Adults With Youth-Onset Diabetes Diagnosed From 2002 to 2015: The SEARCH for Diabetes in Youth Study
Author:
Lawrence Jean M.12ORCID, Reynolds Kristi1ORCID, Saydah Sharon H.3, Mottl Amy4ORCID, Pihoker Catherine5ORCID, Dabelea Dana678, Dolan Lawrence9, Henkin Leora10, Liese Angela D.11ORCID, Isom Scott10, Divers Jasmin12, Wagenknecht Lynne10, Lawrence Jean M.ORCID, Hung Peggy, Koebnick Corinna, Li Xia, Lustigova Eva, Reynolds KristiORCID, Pettitt David J., Mayer-Davis Elizabeth J., Mottl AmyORCID, Thomas Joan, Jackson Malaka, Knight Lisa, Liese Angela D.ORCID, Turley Christine, Bowlby Deborah, Amrhein James, Apperson Elaine, Nelson Bryce, Dabelea Dana, Bellatorre Anna, Crume Tessa, Hamman Richard F., Sauder Katherine A., Shapiro Allison, Testaverde Lisa, Klingensmith Georgeanna J., Maahs David, Rewers Marian J., Wadwa Paul, Daniels Stephen, Kahn Michael G., Wilkening Greta, Bloch Clifford A., Powell Jeffrey, Love-Osborne Kathy, Hu Diana C., Dolan Lawrence M., Shah Amy S., Standiford Debra A., Urbina Elaine M., Pihoker CatherineORCID, Hirsch Irl, Kim Grace, Malik Faisal, Merjaneh Lina, Roberts Alissa, Taplin Craig, Yi-Frazier Joyce, Beauregard Natalie, Franklin Cordelia, Gangan Carlo, Kearns Sue, Klingsheim Mary, Loots Beth, Pascual Michael, Greenbaum Carla, Marcovina Santica M., Chait Alan, Clouet-Foraison Noemie, Harting Jessica, Strylewicz Greg, D’Agostino Ralph, Jensen Elizabeth T., Wagenknecht Lynne E., Casanova Ramon, Divers Jasmin, Goldstein Maureen T., Henkin Leora, Isom Scott, Lenoir Kristin, Pierce June, Reboussin Beth, Rigdon Joseph, South Andrew Michael, Stafford Jeanette, Suerken Cynthia, Wells Brian, Williams Carrie, Imperatore Giuseppina, Saydah Sharon H., Linder Barbara,
Affiliation:
1. Division of Epidemiologic Research, Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA 2. Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 3. Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Hyattsville, MD 4. Division of Nephrology and Hypertension, University of North Carolina School of Medicine, Chapel Hill, NC 5. Department of Pediatrics, University of Washington, Seattle, WA 6. Lifecourse Epidemiology of Adiposity & Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO 7. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 8. Department of Epidemiology, University of Colorado School of Public Health, Aurora, CO 9. Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 10. Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC 11. Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC 12. Division of Health Services Research, Department of Foundations of Medicine, New York University Long Island School of Medicine, Mineola, NY
Abstract
OBJECTIVE
To examine short-term mortality and cause of death among youth and young adults (YYAs) with youth-onset diabetes.
RESEARCH DESIGN AND METHODS
We included 19,717 YYAs newly diagnosed with diabetes before 20 years of age from 1 January 2002 to 31 December 2015 enrolled in the SEARCH for Diabetes in Youth Study. Of these, 14,721 had type 1; 4,141 type 2; and 551 secondary and 304 other/unknown diabetes type. Cases were linked with the National Death Index through 31 December 2017. We calculated standardized mortality ratios (SMRs) and 95% CIs based on age, sex, and race/ethnicity for state and county population areas and examined underlying causes of death.
RESULTS
During 170,148 person-years (PY) (median follow-up 8.5 years), 283 individuals died: 133 with type 1 (103.0/100,000 PY), 55 with type 2 (161.5/100,000 PY), 87 with secondary (1,952/100,000 PY), and 8 with other/unknown diabetes type (312.3/100,000 PY). SMRs (95% CI) for the first three groups were 1.5 (1.2–1.8), 2.3 (1.7–3.0), and 28.0 (22.4–34.6), respectively. Diabetes was the underlying cause of death for 42.1%, 9.1%, and 4.6% of deaths, respectively. The SMR was greater for type 2 than for type 1 diabetes (P < 0.001). SMRs were significantly higher for individuals with type 1 diabetes who were <20 years of age, non-Hispanic White and Hispanic, and female and for individuals with type 2 diabetes who were <25 years of age, from all race/ethnic minority groups, and from both sexes.
CONCLUSIONS
Excess mortality was observed among YYAs for each type of diabetes with differences in risk associated with diabetes type, age, race/ethnicity, and sex. The root causes of excess mortality among YYAs with diabetes merit further study.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
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