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
Authors: Lawrence Jean M. , Reynolds Kristi , Saydah Sharon H. , Mottl Amy , Pihoker Catherine , Dabelea Dana , Dolan Lawrence , Henkin Leora , Liese Angela D. , Isom Scott , Divers Jasmin , Wagenknecht Lynne ,   SEARCH for Diabetes in Youth Study Group, Lawrence Jean M. , Hung Peggy , Koebnick Corinna , Li Xia , Lustigova Eva , Reynolds Kristi , Pettitt David J. , Mayer-Davis Elizabeth J. , Mottl Amy , Thomas Joan , Jackson Malaka , Knight Lisa , Liese Angela D. , Turley Christine , Bowlby Deborah , Amrhein James , Apperson Elaine , Nelson Bryce , Dabelea Dana , Bellatorre Anna , Crume Tessa , Hamman Richard F. , Sauder Katherine A. , Shapiro Allison , Testaverde Lisa , Klingensmith Georgeanna J. , Maahs David , Rewers Marian J. , Wadwa Paul , Daniels Stephen , Kahn Michael G. , Wilkening Greta , Bloch Clifford A. , Powell Jeffrey , Love-Osborne Kathy , Hu Diana C. , Dolan Lawrence M. , Shah Amy S. , Standiford Debra A. , Urbina Elaine M. , Pihoker Catherine , Hirsch Irl , Kim Grace , Malik Faisal , Merjaneh Lina , Roberts Alissa , Taplin Craig , Yi-Frazier Joyce , Beauregard Natalie , Franklin Cordelia , Gangan Carlo , Kearns Sue , Klingsheim Mary , Loots Beth , Pascual Michael , Greenbaum Carla , Marcovina Santica M. , Chait Alan , Clouet-Foraison Noemie , Harting Jessica , Strylewicz Greg , D’Agostino Ralph , Jensen Elizabeth T. , Wagenknecht Lynne E. , Casanova Ramon , Divers Jasmin , Goldstein Maureen T. , Henkin Leora , Isom Scott , Lenoir Kristin , Pierce June , Reboussin Beth , Rigdon Joseph , South Andrew Michael , Stafford Jeanette , Suerken Cynthia , Wells Brian , Williams Carrie , Imperatore Giuseppina , Saydah Sharon H. , Linder Barbara 
Published: October 2021

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 &lt; 0.001). SMRs were significantly higher for individuals with type 1 diabetes who were &lt;20 years of age, non-Hispanic White and Hispanic, and female and for individuals with type 2 diabetes who were &lt;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.