Mortality in African-Americans with Type 1 diabetes: The New Jersey 725

To determine rates and risk factors for all-cause mortality in African-Americans with Type 1 diabetes from a 3-year observational follow-up study of 725 African-Americans with Type 1 diabetes conducted between 1 January 1999 and 31 December 2001.

Date of death was ascertained either from telephone contact with the patient's family or from relatives or on line review of the US Social Security death index.

Since the initial examination, 131 (18.1%) patients, 60 (20%) men and 71 (17%) women, have died. At the time of death, the mean age of the men was 40.7 +/- 10.6 years and that of the women 39.4 +/- 10.5 years. The median duration of diabetes at the baseline examination was 8.04 years, interquartile range (IQR) 3.76-15.22 years for men and median 10.54, IQR 4.49-18.36 years for women. Three-year mortality rates were 7.1% for women and 10.6% for men. Age-adjusted mortality rates were not significantly different between men and women. Relative to the general US and the New Jersey African-American population, standardized mortality ratios of African-Americans with Type 1 diabetes were 12 and six times greater for women and men, respectively. Older age, low socio-economic status, low body mass index, high diastolic blood pressure, macroangiopathy, proteinuria, severe diabetic retinopathy and heavy alcohol consumption were independent risk factors for all-cause mortality. In patients with microproteinuria at initial examination, the mortality rate for men was twice that of women.

Microproteinuria and other potentially modifiable factors, including hypertension, macroangiopathy and heavy alcohol consumption, are independent risk factors for mortality in this ethnic group.