Diabetes Care, Vol 18, Issue 4 476-482, Copyright © 1995 by American Diabetes Association
High risk of IDDM in African-American and Hispanic children in Chicago, 1985-1990
RB Lipton and JA Fivecoate
University of Illinois at Chicago School of Public Health, Division of Epidemiology and Biostatistics 60612, USA.
OBJECTIVE--To determine the incidence of insulin-dependent diabetes
mellitus (IDDM) among African-American and Hispanic children < 18 years
of age in the city of Chicago. These minority communities are large and
heterogeneous with respect to socioeconomic status, length of time since
migration, and place of origin, so that correlates of IDDM risk can be
examined with precision. RESEARCH DESIGN AND METHODS--Cases occurring
during the years 1985-1990 were drawn from records at 37 hospitals in Cook
County. African-American and Hispanic patients using insulin, residing
within the city limits, and < 18 years old at onset were included. Three
secondary sources of cases were used: medical records of clinics associated
with the Chicago Department of Health, a survey of unaffiliated
neighborhood clinics, and lists of children attending diabetes camps.
Overall ascertainment was estimated at 86%. RESULTS-- There were 413 new
cases during this 6-year interval. The average incidence of IDDM was
12.0/100,000 annually among African-American males, 12.1 among
African-American females, 9.1 among Hispanic males, and 10.2 among Hispanic
females. Mean age at onset was 11.1, 11.0, 10.7, and 10.1 years for
African-American males, African-American females, Hispanic males, and
Hispanic females, respectively. Fewer cases occurred during the summer
months. Diabetes among the first-degree relatives of children from both
ethnic groups was commonly noted on the medical charts. CONCLUSIONS--The
incidence rates in Chicago fall near the upper limits of reports for both
African-origin and Hispanic populations worldwide. The relatively early age
at onset may point to an environmental factor associated with this high
incidence of the disease. Further studies will provide valuable data on
comorbid conditions, unusual diabetic syndromes, and family dynamics in
childhood chronic disease.