Differences in diabetes prevalence, incidence, and mortality among the elderly of four racial/ethnic groups: Whites, blacks, Hispanics, and Asians

Division of Health Services Research and Policy, University of Minnesota School of Public Health, MMC 97, Mayo Memorial Building, 420 Delaware St. SE, Minneapolis, MN 55455, USA.
Diabetes Care (Impact Factor: 8.57). 10/2004; 27(10):2317-24. DOI: 10.2337/diacare.27.10.2317
Source: PubMed

ABSTRACT To examine diabetes prevalence, incidence, and mortality from 1993 to 2001 among fee-for-service Medicare beneficiaries > or = 67 years of age.
This study was a retrospective analysis of a 5% random sample of Medicare fee-for-service beneficiaries > or = 65 years of age in each year.
In 1993, the prevalence of diabetes among those > or = 67 years of age was 145 cases per 1,000 individuals. By 2001, it was 197/1,000, an increase of 36.0%. The 2001 prevalence among Hispanics (334/1,000) was significantly higher than among blacks (296/1,000), Asians (243/1,000), and whites (184/1,000, P < 0.0001). During the 7-year period the greatest increase in diabetes prevalence was among Asians (68.0%). Between 1994 and 2001, the annual rate of newly diagnosed elderly individuals with diabetes increased by 36.9%. Hispanics had the greatest increase at 55.0%. The mortality rate among individuals with diabetes decreased by approximately 5% between 1994 and 2001 from 92.1/1,000 to 87.2/1,000 (P < 0.001), due to a 6% decrease among whites. No decrease in mortality was seen among elderly individuals without diabetes, it was 55/1,000 in 1994 and 54/1,000 in 2001.
The dramatic increase in the incidence and prevalence of diabetes likely reflect a combination of true increases, as well as changes in the diagnostic criteria and increased interest in diagnosing and appropriately treating diabetes in the elderly. Improved treatment may have had an impact on mortality rates among individuals with diabetes, although they could have been influenced by the duration of diabetes before diagnosis, which has likely decreased. Changes in incidence, prevalence, and mortality in elderly individuals with diabetes need to continue to be monitored.

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    • "For instance, a study in Barbados found an almost five times higher prevalence of diabetes mellitus and more severe manifestations of this condition in Blacks than in mixed Black and Whites, Whites, and other participants (Hennis et al., 2002). Furthermore, a retrospective analysis in Acad J Sur 2013 (4) 365 -371 the USA of the prevalence, incidence, and mortality of diabetes mellitus from 1993 to 2001 among fee-for-service Medicare beneficiaries of 65 years and older, reported a higher prevalence in Hispanics, Blacks, and Asians when compared to Whites (McBean et al., 2004). In line with these observations, diabetes mellitus prevalence appeared to be at least twice times higher in Japanese, Native Hawaiians, African Americans, and Latinos when compared to Caucasians after correction for body mass index (Maskarinec et al., 2009). "
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    ABSTRACT: The prevalence of diabetes mellitus is increasing in many parts of the world including various Third World countries. Higher prevalence has been demonstrated in several ethnic groups including the descendants of Asia and Africa. This may also hold true for Suriname suggesting a high prevalence of diabetes mellitus here, but this remains to be determined. The purpose of this paper is to review the current information available concerning the prevalence of diabetes in Suriname as well as in the several ethnic groups. Information has been obtained from academic libraries such as PubMed and Hinari, and from the Ministry of Health in Suriname, respectively. Although scant and not always in line with each other, our findings support a significant prevalence, incidence, and mortality of diabetes mellitus in Suriname, as well as the apparent existence of ethnic differences in its distribution. These observations substantiate that this condition represents a hidden public health threat in this country.
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    • "Many comorbidities are common in the aging population, which may further affect the aging HIV-infected brain. Aging is associated with increased incidence of cardiovascular diseases, including hypertension and stroke (Gorelick et al. 2011), as well as diabetes (McBean et al. 2004) and depression (Vink et al. 2009). In addition, particular genotypes (e.g., APOEe4 allele) may further prevent the normal repair processes needed for the aging brain and HIVassociated neurodegeneration (Chang et al. 2011). "
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    ABSTRACT: Highly active antiretroviral therapy (HAART) has increased life expectancy among HIV-infected individuals, and by 2015, at least half of all HIV-infected individuals will be over 50 years of age. Neurodegenerative processes associated with aging may be facilitated by HIV-1 infection, resulting in premature brain aging. This review will highlight brain abnormalities in HIV patients in the setting of aging, focusing on recent neuroimaging studies of the structural, physiological, functional and neurochemical changes. Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy studies performed during the pre-HAART era or on antiretroviral-naive subjects suggest an accelerated aging process, while those on HAART-treated subjects suggest premature brain atrophy. Diffusion tensor imaging studies yielded conflicting findings on the relationship between HIV and age in neuroasymptomatic individuals. Functional MRI studies found evidence of premature or accelerated aging processes in the brains of HIV subjects. Lastly, many age-related illnesses such as diabetes, stroke, and depression, as well as comorbid substance abuse, may further exacerbate the aging process in the HIV-infected brain, leading to premature or accelerated age-related brain changes. Given the different pathologic or physiologic changes in the brain assessed by the different neuroimaging techniques, using a multimodal approach in longitudinal follow-up studies is recommended for future studies.
    Journal of NeuroVirology 06/2012; 18(4):291-302. DOI:10.1007/s13365-012-0114-1 · 3.32 Impact Factor
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    • "Considering the migration patterns in Canada, and recognising the greater susceptibility to dysglycemia among immigrants, especially those of Latino, Asian, South Asian and African heritage, it is important to be able to locate and support populations at higher risk for developing DM (Mitchell et al. 1999, McBean et al. 2004, Public Health Agency of Canada 2009a,b). "
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    ABSTRACT: otero lm, fong m, papineau d, thorne s & zanetti ml (2011) Journal of Nursing and Healthcare of Chronic Illness3, 329–338 Testing a prediabetes screening approach for a Latin American population in Vancouver, CanadaAim.  To determine whether the CANRISK Diabetes Risk Assessment tool can be a useful component of a screening programme to identify risk for developing diabetes mellitus type 2 (DM) in a Latin American immigrant population in a Canadian urban health service region.Background.  Diabetes mellitus type 2 prevalence is rapidly increasing and has been identified as a population health priority. Immigrants from Latin American countries are among the higher risk ethnic groups within the diverse Canadian urban population.Method.  Within a larger multi-site project to validate the Public Health Agency of Canada’s CANRISK Questionnaire, we studied a convenience sample of 44 Spanish- and Portuguese-speaking Latin Americans to assess its utility as a potential component of a prediabetes risk screening approach with this population. Using a cross-sectional exploratory design, we compared CANRISK questionnaire results with values derived from controlled blood glucose testing. Data were collected from 2009–2010.Results.  CANRISK assessment was readily accepted within this population when administered in study participants’ native language. Laboratory testing detected abnormal fasting plasma glucose (FPG) values in 4·7% of this population, 4·5% with abnormal oral glucose tolerance test (OGTT) in 4·5% and abnormal haemoglobin A1c values in 9·1%. In contrast, the CANRISK tool identified 11·4% of the sample to be at high risk, 9·1 at moderate risk and 43·2% at slightly elevated risk for developing DM.Conclusion.  CANRISK identified candidates who might benefit from risk reduction interventions in whom biological indices typically signalling the need for attention were not yet apparent. It is easily administered with this higher risk population, and may be useful to identify a significantly wider spectrum of prediabetes risk than can be detected clinically.Relevance to clinical practice.  Nurses may consider using the CANRISK questionnaire to detect DM risk within this population as an adjunct to prevention strategies aimed at reducing the incidence and prevalence of this disease.
    Journal of Nursing and Healthcare of Chronic Illness 08/2011; 3(3):329 - 338. DOI:10.1111/j.1752-9824.2011.01110.x
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