Mortality risk similar for White vs Black diabetics

By Sally Robertson, B.Sc.Aug 29 2012

Diabetes does not lead to an intrinsically poorer survival in African Americans than it does in White Americans, report US researchers.

After accounting for socioeconomic status (SES) and other risk factors, disparities in diabetes survival between the races are small, says the team, with American Africans actually having a slightly more favorable survival odds than their White counterparts.

In an analysis of 64,096 participants recruited from community health centers between 2002 and 2008, 13.5% of the diabetic population and 7.3% of those without diabetes died during a mean follow-up period of 5.9 years.

All-cause mortality was increased by nearly 90% among individuals with diabetes compared with those without the condition.

In multivariate analysis adjusting for gender, body mass index, cardiovascular disease (CVD), hypertension, stroke/transient ischemia attack (TIA), high cholesterol, smoking history, education, income, and health insurance status, this excess risk was not significantly higher among African Americans than it was among White Americans, at respective hazard ratios (HRs) of 1.84 and 1.80.

Further analysis comparing characteristics among the diabetic population only, showed that African Americans in fact had a 22% lower mortality risk than White Americans, a pattern that held in both men and women, report Baqiyyah Conway (Vanderbilt University, Nashville, Tennessee) et al in Diabetes Care.

"Thus the reported twofold-higher national diabetes mortality rates observed among African Americans compared with whites do not appear to be predominantly biologically based," says the team.

It is possible that other studies were reporting deaths attributable to diabetes in the general population where African Americans are more likely to have and die from diabetes, say the researchers. "We were conditioning on having diabetes and looking at survival among African Americans and whites with this disease."

Their study has therefore removed the effects of a higher incidence of diabetes among African Americans as well as the effect of SES, they say.

The team adds that other significant predictors of mortality were the use of insulin therapy, prevalent CVD, stroke/TIA, and hypertension.

"Reasons for the slightly lower mortality risk observed among African Americans than whites in our population may in part be related to a lower risk of coronary artery disease in African Americans," add Conway and team.

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