Ethnicity and Sex Affect Diabetes Incidence and Outcomes

Diabetes Care - Tập 34 Số 1 - Trang 96-101 - 2011
Nadia Khan1, Hong Wang2, Sonia S. Anand3, Yan Jin4, Norman R.C. Campbell5, Louise Pilote6, Hude Quan7
1Division of General Internal Medicine, University of British Columbia, British Columbia, Canada;
2Center for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada
3Department of Medicine, McMaster University, Hamilton, Ontario, Canada
4Alberta Health and Wellness, Ministry of Health, Edmonton, Alberta, Canada;
5Division of General Internal Medicine, University of Calgary, Calgary, Alberta, Canada
6Division of General Internal Medicine, McGill University, Montreal, Quebec, Canada
7Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada

Tóm tắt

OBJECTIVE Diabetes guidelines recommend aggressive screening for type 2 diabetes in Asian patients because they are considered to have a higher risk of developing diabetes and potentially worse prognosis. We determined incidence of diabetes and risk of death or macrovascular complications by sex among major Asian subgroups, South Asian and Chinese, and white patients with newly diagnosed diabetes. RESEARCH DESIGN AND METHODS Using population-based administrative data from British Columbia and Alberta, Canada (1997–1998 to 2006–2007), we identified patients with newly diagnosed diabetes aged ≥35 years and followed them for up to 10 years for death, acute myocardial infarction, stroke, or hospitalization for heart failure. Ethnicity was determined using validated surname algorithms. RESULTS There were 15,066 South Asian, 17,754 Chinese, and 244,017 white patients with newly diagnosed diabetes. Chinese women and men had the lowest incidence of diabetes relative to that of white or South Asian patients, who had the highest incidence. Mortality in those with newly diagnosed diabetes was lower in South Asian (hazard ratio 0.69 [95% CI 0.62–0.76], P < 0.001) and Chinese patients (0.69 [0.63–0.74], P < 0.001) then in white patients. Risk of acute myocardial infarction, stroke, or heart failure was similar or lower in the ethnic groups relative to that of white patients and varied by sex. CONCLUSIONS The incidence of diagnosed diabetes varies significantly among ethnic groups. Mortality was substantially lower in South Asian and Chinese patients with newly diagnosed diabetes than in white patients.

Từ khóa


Tài liệu tham khảo

Ramachandran, 1997, Rising prevalence of NIDDM in an urban population in India, Diabetologia, 40, 232, 10.1007/s001250050668

Pan, 1997, Prevalence of diabetes and its risk factors in China, 1994. National Diabetes Prevention and Control Cooperative Group, Diabetes Care, 20, 1664, 10.2337/diacare.20.11.1664

McKeigue, 1991, Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians, Lancet, 337, 382, 10.1016/0140-6736(91)91164-P

Simmons, 1989, Prevalence of diabetes in a predominantly Asian community: preliminary findings of the Coventry diabetes study, BMJ, 298, 18, 10.1136/bmj.298.6665.18

Kramer, 2004, Racial/ethnic differences in hypertension and hypertension treatment and control in the Multi-Ethnic Study of Atherosclerosis (MESA), Am J Hypertens, 17, 963, 10.1016/j.amjhyper.2004.06.001

Statistics Canada [article online], 2006. Available from http://www.statcan.gc.ca. Accessed 26 July 2010

Alberta Health and Wellness. Comparison of Alberta population counts between the AHCIP Registry and the 2006 Census [article online], 2006. Available from http://www.health.alberta.ca/documents/Population-2006-Comparison-2009.pdf. Accessed 26 July 2010

Lipscombe, 2007, Trends in diabetes prevalence, incidence, and mortality in Ontario, Canada 1995–2005: a population-based study, Lancet, 369, 750, 10.1016/S0140-6736(07)60361-4

Chen, 2010, Validating ICD coding algorithms for diabetes mellitus from administrative data, Diabetes Res Clinical Pract, 89, 189, 10.1016/j.diabres.2010.03.007

Quan, 2006, Development and validation of a surname list to define Chinese ethnicity, Med Care, 44, 328, 10.1097/01.mlr.0000204010.81331.a9

Nam Pehchan News, 1998, Computer Services, Bradford Council (Dept 13)

Cummins, 1999, An assessment of the Nam Pehchan computer program for the identification of names of South Asian ethnic origin, J Public Health Med, 21, 401, 10.1093/pubmed/21.4.401

Harding, 1999, The potential to identify South Asians using a computerised algorithm to classify names, Popul Trends, 97, 46

Monami, 2007, Are comorbidity indices useful in predicting all-cause mortality in type 2 diabetic patients? Comparison between Charlson index and disease count, Aging Clin Exp Res, 19, 492, 10.1007/BF03324736

Varas-Lorenzo, 2008, Positive predictive value of ICD-9 codes 410 and 411 in the identification of cases of acute coronary syndromes in the Saskatchewan Hospital automated database, Pharmacoepidemiol Drug Saf, 17, 842, 10.1002/pds.1619

Kokotailo, 2005, Coding of stroke and stroke risk factors using International Classification of Diseases, revisions 9 and 10, Stroke, 36, 1776, 10.1161/01.STR.0000174293.17959.a1

Goff, 2000, Congestive heart failure in the United States: is there more than meets the I(CD code)? The Corpus Christi Heart Project, Arch Intern Med, 160, 197, 10.1001/archinte.160.2.197

Nettleton, 2008, Dietary patterns and risk of incident type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA), Diabetes Care, 31, 1777, 10.2337/dc08-0760

Chandie Shaw, 2006, South-Asian type 2 diabetic patients have higher incidence and faster progression of renal disease compared with Dutch-European diabetic patients, Diabetes Care, 29, 1383, 10.2337/dc06-0003

McBean, 2004, Differences in diabetes prevalence, incidence, and mortality among the elderly of four racial/ethnic groups: whites, blacks, Hispanics, and Asians, Diabetes Care, 27, 2317, 10.2337/diacare.27.10.2317

Sheth, 1999, Cardiovascular and cancer mortality among Canadians of European, south Asian and Chinese origin from 1979 to 1993: an analysis of 1.2 million deaths, CMAJ, 161, 132

Mather, 1998, Mortality and morbidity from diabetes in South Asians and Europeans: 11 year follow-up of the Southall Diabetes Survey, London, UK, Diabet Med, 15, 53, 10.1002/(SICI)1096-9136(199801)15:1<53::AID-DIA521>3.0.CO;2-V

Quan, 2006, Variation in health services utilization among ethnic populations, CMAJ, 174, 787, 10.1503/cmaj.050674

Karter, 2002, Ethnic disparities in diabetic complications in an insured population, JAMA, 287, 2519, 10.1001/jama.287.19.2519

Fischbacher, 2009, Is there equity of service delivery and intermediate outcomes in South Asians with type 2 diabetes? Analysis of DARTS database and summary of UK publications, J Public Health (Oxf), 31, 239, 10.1093/pubmed/fdp003

Thông tin
Thông tin xuất bản

Diabetes Care

Tập 34 Số 1

96-101

Thông tin tác giả