Washington, Raynard
(2012)
Epidemiology of Type 1 Diabetes Complications in African-Americans.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Unlike type 2 diabetes, where prevention is possible, type 1 diabetes is a lifelong incurable metabolic disorder. The annual incidence of type 1 diabetes continues to rise annually. Despite increased access to treatment and improved disease management, type 1 diabetes is associated with excess morbidity and early mortality. African-Americans with type 1 diabetes are at increased risk of premature mortality compared to Caucasians. This disparity is likely fueled by differences in the prevalence of complications; however, there is limited information available on the racial differences in type 1 diabetes complications in individuals of African descent (i.e. African-American, Afro-Caribbean). Using the data from the U.S. Virgin Islands Childhood Diabetes Registry, this dissertation provides contemporary insights on the incidence of childhood diabetes in African-American youth and for the first time evaluates type 1 diabetes mortality in African-Americans, in the U.S. Virgin Islands. In addition, this dissertation assesses racial differences in the prevalence of type 1 diabetes complications and risk factors using a national sample from the National Health and Nutrition Examination Survey.
The incidence of type 1 and type 2 diabetes in youth in the U.S. Virgin Islands is rapidly increasing. The well-established pubertal increase in type 1 diabetes incidence appears to be missing in African-American boys. Individuals diagnosed at later ages (>14), have significantly higher risk of mortality compared to those diagnosed at earlier ages. Despite advances in diabetes care, there were no temporal improvements observed in mortality in the U.S. Virgin Islands. African-Americans in the U.S. Virgin Islands had a similar type 1 diabetes mortality experience as African-Americans in Allegheny County, PA. African-Americans in the national sample had significantly higher rates of nephropathy and retinopathy. Race was associated with both complications, even after adjusting for clinical and demographic factors.
The public health implications of this dissertation are considerable, as it provides insight on the burden of type 1 diabetes in the U.S. Virgin Islands and African-Americans in the U.S. These findings provide evidence to support additional services and potentially intensive diabetes management strategies for African-Americans with type 1 diabetes.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
| Creators | Email | Pitt Username | ORCID  |
|---|
| Washington, Raynard | rew11@pitt.edu | REW11 | |
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| ETD Committee: |
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| Date: |
29 June 2012 |
| Date Type: |
Completion |
| Defense Date: |
27 March 2012 |
| Approval Date: |
29 June 2012 |
| Submission Date: |
4 April 2012 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
133 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
DrPH - Doctor of Public Health |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Type 1 diabetes, Epidemiology, complications |
| Additional Information: |
Final Version of ETD |
| Date Deposited: |
29 Jun 2012 18:16 |
| Last Modified: |
15 Nov 2016 13:57 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/11708 |
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