TY - JOUR
T1 - Incidence of insulin-requiring diabetes in the US military
AU - Gorham, E. D.
AU - Barrett-Connor, E.
AU - Highfill-Mcroy, R. M.
AU - Mohr, S. B.
AU - Garland, C. F.
AU - Garland, F. C.
AU - Ricordi, C.
N1 - Funding Information:
Acknowledgements This research was supported by a Congressional allocation to the Diabetes Research Institute, University of Miami, Miller School of Medicine in Miami, FL, USA, through the Department of the Navy, Bureau of Medicine and Surgery, under Work Unit No. 60126. The views expressed in this report are those of the authors and do not represent an official position of the Department of the Navy, Department of Defense or the US Government. The study has been approved for public release with unlimited distribution. The authors express their gratitude to: R. Guerin, Director, Tricare Health Programs Analysis and Evaluation Branch; S. Jenkins of the Tricare Management Activity Privacy Office; the Tricare Chief Information Officer and the staff of the Tricare Executive Information and Decision Support System. We also thank our Naval Health Research Center colleague E. E. K. Gunderson, who brought together the system of medical databases that were used to perform this study, M. Miller and T. Nedellec for maintaining the data sets that were used to perform the study, and S. Hilton for consultation on SPSS programming methods. Thanks are also extended to D. Washington of Tricare and Axion, who helped the authors obtain access to Tricare medical data, to M. Dove, V. Lauter and S. Seggerman of the Management Information and Analysis Division, Defense Manpower Data Center-West, who provided data on population denominators, and to the Defense Medical Epidemiology Database of the Army, whose DMED online website provided denominator data for some analyses. We also thank A.A. Burgi (Naval Health Research Center), who read and commented on the manuscript.
PY - 2009/10
Y1 - 2009/10
N2 - Aims/hypothesis: The aim of the study was to determine age- and race-related, and overall incidence rates of insulin-requiring diabetes in adults in the US military. Methods: Electronic records for admissions to US military and Tricare hospitals during 1990-2005 and visits to military clinics during 2000-2005 were identified using the Career History Archival Medical and Personnel System at the Naval Health Research Center, San Diego, CA, USA. Population data were obtained from the Defense Manpower Data Center and Defense Medical Epidemiology Database. Results: In men there were 2,918 new cases of insulin-requiring diabetes in 20,427,038 person-years at ages 18-44 years (median age 28 years) for a total age-adjusted incidence rate of 17.5 per 100,000 person-years (95% CI 16.4-18.6). Incidence rates were twice as high in black men as in white men (31.5 vs 14.5 per 100,000, p<0.001). In women there were 414 new cases in 3,285,000 person-years at ages 18-44 years (median age 27 years), for a total age-adjusted incidence rate of 13.6 per 100,000 (95% CI 12.4-14.9). Incidence rates were twice as high in black women as in white women (21.8 vs 9.7 per 100,000, p<0.001). In a regression model, incidence of insulin-requiring diabetes peaked annually in the winter-spring season (OR 1.46, p<0.01). Race and seasonal differences persisted in the multivariate analysis. Conclusions/interpretation: Differences in incidence rates by race and season suggest a need for further research into possible reasons, including the possibility of a contribution from vitamin D deficiency. Cohort studies using prediagnostic serum 25-hydroxyvitamin D should be conducted to further evaluate this relationship.
AB - Aims/hypothesis: The aim of the study was to determine age- and race-related, and overall incidence rates of insulin-requiring diabetes in adults in the US military. Methods: Electronic records for admissions to US military and Tricare hospitals during 1990-2005 and visits to military clinics during 2000-2005 were identified using the Career History Archival Medical and Personnel System at the Naval Health Research Center, San Diego, CA, USA. Population data were obtained from the Defense Manpower Data Center and Defense Medical Epidemiology Database. Results: In men there were 2,918 new cases of insulin-requiring diabetes in 20,427,038 person-years at ages 18-44 years (median age 28 years) for a total age-adjusted incidence rate of 17.5 per 100,000 person-years (95% CI 16.4-18.6). Incidence rates were twice as high in black men as in white men (31.5 vs 14.5 per 100,000, p<0.001). In women there were 414 new cases in 3,285,000 person-years at ages 18-44 years (median age 27 years), for a total age-adjusted incidence rate of 13.6 per 100,000 (95% CI 12.4-14.9). Incidence rates were twice as high in black women as in white women (21.8 vs 9.7 per 100,000, p<0.001). In a regression model, incidence of insulin-requiring diabetes peaked annually in the winter-spring season (OR 1.46, p<0.01). Race and seasonal differences persisted in the multivariate analysis. Conclusions/interpretation: Differences in incidence rates by race and season suggest a need for further research into possible reasons, including the possibility of a contribution from vitamin D deficiency. Cohort studies using prediagnostic serum 25-hydroxyvitamin D should be conducted to further evaluate this relationship.
KW - Incidence rates
KW - Insulin-requiring diabetes
KW - Race
KW - Seasonality
KW - Sex
KW - Vitamin D
KW - Young adults
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U2 - 10.1007/s00125-009-1449-x
DO - 10.1007/s00125-009-1449-x
M3 - Article
C2 - 19629431
AN - SCOPUS:69949140749
VL - 52
SP - 2087
EP - 2091
JO - Diabetologia
JF - Diabetologia
SN - 0012-186X
IS - 10
ER -
