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American Journal of Epidemiology Vol. 129, No. 4: 723-731
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health

research-article

CLUSTERING OF PREMATURE MORTALITY IN 1, 761 INSULINDEPENDENT DIABETICS AND THEIR FAMILY MEMBERS

JILL M. NORRIS1,, JANICE S. DORMAN1, RONALD E. LAPORTE1, MARIAN REWERS1, JEFFREY A. GAVARD1, TREVOR J. ORCHARD1, DOROTHY J. BECKER2, ALLAN L. DRASH2 and LEWIS H. KULLER1

1Department of Epidemiology Graduate School of Public Health, University of Pittsburgh, Pitts burgh, PA
2Division of Endocrinology and Metabolism, Department of Pediatrics Children's Hospital, and Uni versity of Pittsburgh, Pittsburgh, PA

Reprint requests to Jill M. Norris, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261

The clustering of prer mortality was investigated in 1, 761 insulindependent diabetics and their family members from the Children's Hospital of Pittsburgh Insulin-Dependent Diabetes Mellitus Registry from 1950–1981. At follow-up, 5% of the mothers and 13% of the fathers were deceased. Life table analyses revealed that fathers of deceased diabetics were significantly more likely to die prematurely than fathers of living diabetics (18% vs. 8% at age 55 years; p = 0.02). A father-diabetic son concordance of mortality appeared to be responsible for this effect. A similar overall trend was observed for maternal mortality, although the difference was not statistically significant. Cause-specific analyses revealed that the increased paternal mortality was primarily the result of cardiovascular disease. Overall mortality rates of parents of deceased dia betics were higher than those of the general population, reaching statistical significance in the age group 35–44 years (p < 0.05). Mortality among diabetic siblings was also examined. Diabetic siblings of deceased diabetics had a markedly increased risk of dying compared with diabetic siblings of living dia betics (p = 0.001). These findings indicate that premature mortality among both diabetic and nondlabetic relatives of diabetics clusters in families in which there is a deceased insulin-dependent diabetic, and suggest that the marked increase in mortality among persons with insulin-dependent diabetes may be partly under familial control.

diabetes mellitus; insulin-dependent; family; mortality


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