Online Program

Prevalence of major type 1 diabetes complications and risk factors in whites and blacks in the national health and nutrition examination survey (NHANES 1999-2008): Is race a risk factor?

Tuesday, November 5, 2013 : 3:14 p.m. - 3:32 p.m.

Raynard Washington, PhD, MPH, Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Washington, DC
Background: Mortality for non-Hispanic blacks (NHBs) with type 1 diabetes (T1D) is nearly 2.5 times higher than non-Hispanic whites (NHWs) and the factors contributing to this disparity remain unclear. The objectives of this study were to compare the prevalence of T1D complications between NHWs and NHBs in a nationally representative sample and to evaluate the impact of modifiable risk factors and race on these outcomes. Methods: Individuals with T1D were identified in the NHANES 1999-2008 as individuals diagnosed with diabetes less than age 30 and on continuous insulin therapy. Complication and risk factor status were determined based on self-reported questionnaire responses and relevant laboratory components. Results: The prevalence of CVD did not differ by race, and race was not associated with CVD after adjusting for risk factors. The prevalence of nephropathy (NHBs: 48.6%; NHWs: 18.4%, p<.01) and retinopathy (NHBs: 83.1%; NHWs: 43.4%, p=.01) at >20 years duration was significantly higher in NHBs. Race was significantly associated with nephropathy [OR (95%CI): 1.30 (1.11, 1.54)] and retinopathy [OR (95%CI): 1.39 (1.14, 1.70)] after adjusting for clinical and demographic risk factors. Conclusions: These data suggest that NHBs with T1D are at increased risk of developing nephropathy and retinopathy, independent of well-established risk factors for these complications. This disparity may be associated with access to care, non-traditional risk factors, or genetic susceptibility.

Learning Areas:

Chronic disease management and prevention
Diversity and culture
Public health or related research

Learning Objectives:
Describe the impact of race on long term type 1 diabetes compliations.

Keyword(s): Diabetes, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the research for this at the university of Pittsburgh as a doctoral student. I have over 5 years of public health research and programmatic experience to include work in the public and nonprofit sectors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4307.0: Epidemiology of Diabetes