Progress in Preventing Diabetes-Related Deaths in Children Has Stalled
Death rates among children <10 years have plateaued after falling steadily from 1968 to 1995, and rates among youth aged 10 to 19 years have steadily increased following a decline from 1968 to 1984.
An estimated 215,000 children have diabetes. To determine how advances in treatment have affected mortality rates, investigators at the Centers for Disease Control analyzed data from the National Vital Statistics System between1968 and 2009 for all deaths in youth aged <19 years with diabetes listed as an underlying cause.
During the 4 decades, diabetes-related mortality decreased 61%, from an annual rate of 2.69 per million in 1968 and 1969 to 1.05 per million in 2008 and 2009. The decrease in death rate was greater among children younger than 10 years than among those aged 10 to 19 years (78% vs. 52%). Among the younger children, the annual percentage change in death rates was –5.7% between 1968 and 1995, but then slowed dramatically or ceased between 1995 and 2009. Among older youth, the annual percentage change was –6.5% between 1968 and 1984, but then increased 1.6% between 1984 and 2009.
Comment: One possible explanation for the increased death rate among older children is that younger children with diabetes are now surviving to adolescence and dying in the second decade of life. However, such deaths, usually due to acute complications such as ketoacidosis and hypoglycemia, are preventable. That death rates have plateaued for children younger than 10 years and have been increasing for those aged 10 to 19 years indicates that treatment advances alone are not sufficient to prevent diabetes-related deaths. We need to make sure all children with diabetes have access to the latest treatments, and we need to understand better how these youth and their families manage the illness.
Published in Journal Watch Pediatrics and Adolescent Medicine November 21, 2012
Centers for Disease Control and Prevention (CDC). Diabetes death rates among youths aged 19 years — United States, 1968–2009. MMWR Morb Mortal Wkly Rep 2012 Nov 2; 61:869.
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