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Trevor Orchard, M.D.

New Dramatic Drop in Mortality Rates for Type 1 Diabetes in Allegheny County, Finds University of Pittsburgh Study

PITTSBURGH, April 26, 2001 — Mortality rates for people with type 1 diabetes are on the decline for the first time in Allegheny County since researchers at the University of Pittsburgh Graduate School of Public Health began tracking these rates 20 years ago. Investigators believe this drop may be occurring nationwide.

They report on their findings in the May issue of Diabetes Care, a journal of the American Diabetes Association.

“For Allegheny County children diagnosed with type 1 diabetes in the late 1970s, the chance of dying after 20 years has dropped by more than 50 percent,” said Senior Investigator Trevor Orchard, M.D., professor of epidemiology, medicine and pediatrics. “These dramatic changes reflect the improvements in diabetes management that began in the early 1980s, once patients were able to monitor their blood sugars better and physicians could monitor the effects of treatment changes using the hemoglobin A1c test – a long-term blood sugar test. We suspect these changes are likely to be seen generally, beyond Allegheny County.”

Type 1 diabetes usually begins before the age of 30 and affects some 750,000 Americans. People with this disease have lost their ability to produce the hormone insulin, which controls blood sugar, and therefore they require daily insulin injections. For more than 20 years, Dr. Orchard and his colleagues have been following 1,075 type 1 diabetes patients in Allegheny County (Pittsburgh, Pa.) who were diagnosed between 1965 and 1979. Until recently, these patients experienced a consistently high mortality rate. Their most recent analysis, however, shows a first-time, significant drop in mortality rate among those diagnosed later in the 14-year period.

Of the 1,075 patients identified at the study’s start in 1980, 75 deaths were observed in the 20 years after diagnosis, with significantly more deaths occurring among patients diagnosed in 1965-1969 (33 patients, or 8.4 percent) than among those diagnosed in 1975-1979 (15 patients, or 3.5 percent).

The mortality of African-Americans was significantly higher than that of Caucasians, with 50 percent of African-Americans in the study having died within 20 years of diagnosis.

“While mortality was higher among African-Americans with type 1 diabetes than it was among Caucasians with type 1 diabetes, the difference was similar to racial differences in mortality rates among the general population,” said Janice Dorman, Ph.D., associate professor of epidemiology and pediatrics, and study co-investigator. “This indicates that factors unrelated to the diabetes are responsible for the higher death rates.”

“While the results of this study are encouraging, we still have a long way to go in increasing the long-term survival of people with type 1 diabetes,” said Dr. Orchard. “Mortality rates for individuals with this disease are still more than twice what they are for people without diabetes.”

A previous University of Pittsburgh study found that mortality rates for type 1 diabetics in Allegheny County are significantly higher than those in Finland, a country that has one of the highest type 1 diabetic mortality rates.

Established in 1948, the Graduate School of Public Health at the University of Pittsburgh is world-renowned for contributions that have influenced public health practices and medical care for millions of people. It is the only fully accredited school of public health in the Commonwealth of Pennsylvania and is one of the top-ranked schools of public health in the United States. It is one of eight schools across the country to be designated a Public Health Training Center by the U.S. Department of Health and Human Services.

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