Ethnic diversity in type 2 diabetes

Diabetic Medicine : a Journal of the British Diabetic Association
T M E Davis

Abstract

The present review assesses published data relating to the main ethnic groups in the UK Prospective Diabetes Study (UKPDS), namely White Caucasians (WC; 82% of the cohort), Indian-Asians (IA; 10%) and Afro-Caribbeans (AC; 8%). At entry, the IA patients were younger than WC and AC patients, had a greater waist-hip ratio and more sedentary lifestyle, but had the lowest prevalence of hypertension and current smoking. The AC patients had the poorest glycaemic control but the most favourable lipid profile. The differences in modifiable vascular risk factors did not change over 9 years of follow-up. Consistent with UKPDS exclusion criteria, few patients had complications at baseline and there were no between-group differences. An interim analysis of incident fatal/non-fatal myocardial infarction (median follow-up 8.7 years) showed that the AC patients had a 70% lower risk than WC after adjustment for explanatory variables and that IA patients had a similar risk to WC. An analysis of complete albuminuria and renal failure data (median follow-up 15 years) showed that IA ethnicity was independently associated with an increased risk. There are sustained ethnic differences in the nature of diabetes, including vascular risk factors. AC pat...Continue Reading

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