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. 2021 Dec;44(12):2691-2698.
doi: 10.2337/dc21-0728. Epub 2021 Oct 4.

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

Jean M Lawrence  1   2 , Kristi Reynolds  3 , Sharon H Saydah  4 , Amy Mottl  5 , Catherine Pihoker  6 , Dana Dabelea  7   8   9 , Lawrence Dolan  10 , Leora Henkin  11 , Angela D Liese  12 , Scott Isom  11 , Jasmin Divers  13 , Lynne Wagenknecht; SEARCH for Diabetes in Youth Study Group; SEARCH for Diabetes in Youth Study Group:
Collaborators, Affiliations

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

Jean M Lawrence et al. Diabetes Care. 2021 Dec.

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.

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Figures

Figure 1
Figure 1
SMRs and 95% CIs for type 1 (A) and type 2 (B) diabetes overall and by sex, race/ethnicity, and age at death or end of follow-up. The number on the top of or beside the bar is the SMR. The error bars show the range of the 95% CI. The top of the error bar for <15 years in B is 24.9.
See this image and copyright information in PMC

References

    1. Divers J, Mayer-Davis EJ, Lawrence JM, et al. . Trends in incidence of type 1 and type 2 diabetes among youths - selected counties and Indian reservations, United States, 2002-2015. MMWR Morb Mortal Wkly Rep 2020;69:161–165 - PMC - PubMed
    1. Lawrence JM, Divers J, Isom S, et al. .; SEARCH for Diabetes in Youth Study Group . Trends in prevalence of type 1 and type 2 diabetes in children and adolescents in the US, 2001-2017. JAMA 2021;326:717–727 - PMC - PubMed
    1. Imperatore G, Boyle JP, Thompson TJ, et al. .; SEARCH for Diabetes in Youth Study Group . Projections of type 1 and type 2 diabetes burden in the U.S. population aged <20 years through 2050: dynamic modeling of incidence, mortality, and population growth. Diabetes Care 2012;35:2515–2520 - PMC - PubMed
    1. Morgan E, Cardwell CR, Black CJ, McCance DR, Patterson CC. Excess mortality in type 1 diabetes diagnosed in childhood and adolescence: a systematic review of population-based cohorts. Acta Diabetol 2015;52:801–807 - PubMed
    1. Evans-Cheung TC, Bodansky HJ, Parslow RC, Feltbower RG. Mortality and acute complications in children and young adults diagnosed with type 1 diabetes in Yorkshire, UK: a cohort study. Diabet Med 2018;35:112–120 - PubMed

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