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
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.