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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

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posted on 04.10.2021, 17:00 by Jean M Lawrence, Kristi Reynolds, Sharon H Saydah, Amy Mottl, Catherine Pihoker, Dana Dabelea, Lawrence Dolan, Leora Henkin, Angela D Liese, Scott Isom, Jasmin Divers, Lynne Wagenknecht, the SEARCH for Diabetes in Youth Study Group
OBJECTIVE: To examine short-term mortality and cause of death among youth and young adults (YYA) with youth-onset diabetes.

RESEARCH DESIGN AND METHODS: We included 19,717 YYA’s newly-diagnosed with diabetes before age 20 from 1/1/2002–12/31/2015 enrolled in the SEARCH for Diabetes in Youth Study. Of these, 14,721 had type 1; 4,141 type 2; 551 secondary and 304 other/unknown diabetes type. Cases were linked with the National Death Index through 12/31/2017. We calculated standardized mortality ratios (SMR) 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 ages <20 years, non-Hispanic White and Hispanic individuals and females with type 1 diabetes and for ages <25 years, all race/ethnic minority groups and both sexes with type 2 diabetes.

CONCLUSION: Excess mortality was observed among YYA 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 merits further study.

Funding

SEARCH 4: The SEARCH for Diabetes in Youth Cohort Study (1R01DK127208-01, 1UC4DK108173) is funded by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases and supported by the Centers for Disease Control and Prevention. The Population Based Registry of Diabetes in Youth Study (1U18DP006131, U18DP006133, U18DP006134, U18DP006136, U18DP006138, U18DP006139) is funded by the Centers for Disease Control and Prevention (DP-15-002) and supported by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. SEARCH 1-3: SEARCH for Diabetes in Youth is funded by the Centers for Disease Control and Prevention (PA numbers 00097, DP-05-069, and DP-10-001) and supported by the National Institute of Diabetes and Digestive and Kidney Diseases. Kaiser Permanente Southern California (U48/CCU919219, U01 DP000246, and U18DP002714), University of Colorado Denver (U48/CCU819241-3, U01 DP000247, and U18DP000247-06A1), Cincinnati's Children's Hospital Medical Center (U48/CCU519239, U01 DP000248, and 1U18DP002709), University of North Carolina at Chapel Hill (U48/CCU419249, U01 DP000254, and U18DP002708), Seattle Children's Hospital (U58/CCU019235-4, U01 DP000244, and U18DP002710-01] and Wake Forest University School of Medicine (U48/CCU919219, U01 DP000250, and 200-2010-35171).

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