Abstract
Background: Asian migrants represent an expanding proportion of the Australian
population and are from a region with an increasing diabetes burden. There are few data
detailing the characteristics and outcome of type 2 diabetes in Asian Australians.
Aims: To determine whether the phenotype and prognosis of Asians with type 2
diabetes differ from those in Anglo-Celt (AC) patients from the same Australian
community.
Methods: We studied 44 Asian and 796 AC patients from the Fremantle Diabetes
Study. Each had a detailed assessment between 1993 and 1996, and was invited to
annual reviews for ≥5 years. Data linkage provided additional endpoints to end-2010.
Cox proportional hazards modelling was used to determine predictors of cardiovascular
disease (CVD) death and all-cause mortality.
Results: The prevalence of type 2 diabetes in Asians and the general population in
Fremantle was similar (1.5% vs 1.6%; P = 0.60). The Asian patients were younger, less
obese and less likely to be hypertensive than the AC subjects, but they had a higher
retinopathy prevalence (27.3% vs 13.5%; P = 0.023). During up to 18 years of follow
up, 12 Asians and 428 AC patients died, 2 (16.7%) vs 205 (47.9%) from CVD
(P = 0.040). Asian ethnicity was independently protective against CVD death (hazard
ratio 0.13 (95% confidence interval: 0.02–0.96); P = 0.046) but not all-cause mortality
(hazard ratio 0.58 ( 95% confidence interval: 0.31–1.10); P = 0.10).
Conclusions: The phenotype of type 2 diabetes in a relatively small group of wellcharacterised
Asian Australians differed from that in AC patients from the same urban
community. Their favourable cardiovascular prognosis may reflect a healthy migrant
effect.
population and are from a region with an increasing diabetes burden. There are few data
detailing the characteristics and outcome of type 2 diabetes in Asian Australians.
Aims: To determine whether the phenotype and prognosis of Asians with type 2
diabetes differ from those in Anglo-Celt (AC) patients from the same Australian
community.
Methods: We studied 44 Asian and 796 AC patients from the Fremantle Diabetes
Study. Each had a detailed assessment between 1993 and 1996, and was invited to
annual reviews for ≥5 years. Data linkage provided additional endpoints to end-2010.
Cox proportional hazards modelling was used to determine predictors of cardiovascular
disease (CVD) death and all-cause mortality.
Results: The prevalence of type 2 diabetes in Asians and the general population in
Fremantle was similar (1.5% vs 1.6%; P = 0.60). The Asian patients were younger, less
obese and less likely to be hypertensive than the AC subjects, but they had a higher
retinopathy prevalence (27.3% vs 13.5%; P = 0.023). During up to 18 years of follow
up, 12 Asians and 428 AC patients died, 2 (16.7%) vs 205 (47.9%) from CVD
(P = 0.040). Asian ethnicity was independently protective against CVD death (hazard
ratio 0.13 (95% confidence interval: 0.02–0.96); P = 0.046) but not all-cause mortality
(hazard ratio 0.58 ( 95% confidence interval: 0.31–1.10); P = 0.10).
Conclusions: The phenotype of type 2 diabetes in a relatively small group of wellcharacterised
Asian Australians differed from that in AC patients from the same urban
community. Their favourable cardiovascular prognosis may reflect a healthy migrant
effect.
| Original language | English |
|---|---|
| Pages (from-to) | 1125-1132 |
| Journal | Internal Medicine Journal |
| Volume | 43 |
| Issue number | 10 |
| Early online date | 18 Oct 2013 |
| DOIs | |
| Publication status | Published - Oct 2013 |
