title: Diabetes is more lethal in Mexicans and Mexican-Americans compared to Non-Hispanic whites.
abstract: OBJECTIVE
  To examine the mortality risk associated with diabetes in the Mexico City Diabetes Study (MCDS) and the San Antonio Heart Study (SAHS).
  
  
  METHODS
  Prospective cohorts conducted 1990-2007 in MCDS and 1979-2000 in SAHS. Mortality risk was examined using Cox proportional hazard models in 1402 non-Hispanic whites (NHW), 1907 U.S.-born Mexican-Americans (MA), 444 Mexican-born MA, and 2281 Mexico City residents (MCR) between the ages of 35-64.
  
  
  RESULTS
  Age- and sex-adjusted mortality hazard ratios (HR) comparing U.S.-born MA, Mexican-born MA, and MCR to NHW were 1.09 (95% confidence interval [CI]: 0.86, 1.37), 1.23 (95% CI: 0.86, 1.76), and 0.97 (95% CI: 0.77, 1.23), respectively, in nondiabetic individuals; in contrast, mortality risk varied in diabetic individuals with respective HRs of 1.77 (95% CI: 1.20, 2.61), 1.08 (95% CI: 0.59, 1.97), and 2.27 (95% CI: 1.53, 3.35) (interaction p = .0003). Excluding Mexican-born MA and nondiabetic individuals, controlling for medication use, insulin use, fasting glucose levels, and duration of diabetes explained a significant proportion of the mortality differential (HRs relative to NHW were 1.31 [95% CI: 0.87, 1.98] in U.S.-born MA and 1.38 [95% CI: 0.89, 2.12] in MCR).
  
  
  CONCLUSIONS
  This study provides evidence that diabetes is more lethal in U.S.-born MA and MCR than in NHW.
authors.affiliation: Medical University of South Carolina, Charleston, SC 29425, USA. huntke@musc.edu
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Hunt
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Gonzalez
authors.forename: Ruy
authors.initials: R
authors.lastname: Lopez
authors.forename: Steve M
authors.initials: SM
authors.lastname: Haffner
authors.forename: Michael P
authors.initials: MP
authors.lastname: Stern
authors.forename: Clicerio
authors.initials: C
authors.lastname: Gonzalez-Villalpando
mesh_terms: D000328:Adult; D000367:Age Factors; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality*; D054242:Emigrants and Immigrants / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology / Q000208:ethnology; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data