WAS THERE AN EPIDEMIC AT DIABETES IN NONWHITE ADOLESCENTS IN ALLEGHENY COUNTY, PENNSYLVANIA

OBJECTIVE - To determine the incidence of IDDM in children aged <20 ye ars at diagnosis in Allegheny County, Pennsylvania, for the period fro m 1 January 1990 to 31 December 1994 and to compare the incidence betw een whites and nonwhites in the same area and for the same time period . RESEARCH DESIGN AND METHODS - All new patients diagnosed between Jan uary 1990 and December 1994 who were aged <20 years, on insulin, and r esidents of Allegheny County at diagnosis were identified from medical records of 23 hospitals in the Allegheny County area. To verify the c ompleteness of the hospitals using the capture-recapture method, pedia tricians and diabetologists were used as a secondary source. RESULTS - A total number of 257 patients were identified. The overall age-stand ardized incidence rate was 16.7/100,000. Nonwhites had a slightly high er incidence (17.6/100,000) than whites (16.5/100,000). In the 15-19 y ears age-group, the incidence in nonwhites (30.4/100,000) was almost t hree times higher than that in whites (11.2/100,000) and more than two times higher than that in the previous period (from 1985 to 1989) (13 .8/100,000). CONCLUSIONS - For the first time in the Allegheny County registry, and in any other registry, nonwhites showed a higher inciden ce of IDDM than whites. The high incidence in the 15-19 years age-grou p was responsible for this phenomenon. This epidemic of diabetes in ad olescent nonwhites may be the result of a rising incidence of classica l IDDM or another type of diabetes. Further studies using population-b ased registries are needed to determine whether this increase is being seen in other areas and other ethnic groups and to clarify the reason s for the increase in IDDM among blacks.