Characteristics and prognosis of Asian patients with type 2 diabetes from a multi-racial Australian community: the Fremantle Diabetes Study

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    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.
    Original languageEnglish
    Pages (from-to)1125-1132
    JournalInternal Medicine Journal
    Volume43
    Issue number10
    Early online date18 Oct 2013
    DOIs
    Publication statusPublished - Oct 2013

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