Race and sex differences in rates of diabetic complications

Background Studies on racial differences in diabetic complications are very limited. The aim of this study was to investigate the race and sex differences in diabetic complications between African Americans and Whites with type 2 diabetes (T2D) in Louisiana. Methods A prospective cohort study was performed of 27 113 African Americans and 40 431 Whites with T2D who were 35 to 95 years of age from three healthcare systems located in south Louisiana. Four major diabetic complications were assessed: coronary heart disease (CHD), heart failure, stroke, and end-stage renal disease (ESRD). Results The age- and sex-adjusted incident rates per 1000 person-years and 95% confidence intervals (CI) for CHD, heart failure, stroke, and ESRD for African Americans with diabetes were 43.1 (95% CI 41.6-44.6), 36.6 (95% CI 35.2-37.9), 29.6 (95% CI 28.4-30.8), and 38.3 (95% CI 36.9-39.7), respectively. Cox regression models showed that African American women had a higher risk than White women for heart failure (hazard ratio (HR) 1.26; 95% CI 1.18-1.34), stroke (HR 1.15; 95% CI 1.08-1.22), and ESRD (HR 1.32; 95% CI 1.24-1.40), whereas African American men had higher risks than White men for heart failure (HR 1.33; 95% CI 1.25-1.43) and ESRD (HR 1.47; 95% CI 1.37-1.57) but a lower risk of CHD (HR 0.88; 95% CI 0.83-0.94). Conclusions The incidence of major diabetic complications varied among difference race and sex groups. More race- or sex-specific studies on complications in patients with diabetes are needed to see whether incident rates are changing over time.