Type 2 diabetes and associated health risks in South Asians and white Europeans

Takeaway

• South Asians were at an increased risk for cardiovascular disease (CVD) mortality and incidence, but at a lower risk for cancer mortality and incidence compared with white Europeans.
• In both white Europeans and South Asians, type 2 diabetes (T2D) was associated with an increased risk for all-cause mortality and CVD incidence, but the risk was higher in South Asians than Europeans.

Why this matters

• Findings suggest that preventive measures to prevent or delay the onset of T2D may have the largest effect within the South Asian population.

Study design

• A population-based cohort study included 457,935 white European and 7102 South Asian participants using data from the UK Biobank.
• Funding: The Health Behaviours & Chronic Diseases, Amsterdam Public Health.

Key results

• During a mean follow-up of 7.0 (interquartile range, 6.3-7.6) years, 12,974 participants died, and 30,346 and 27,159 developed CVD and cancer, respectively.
• Compared with Europeans, South Asians were at:
  • higher risk for CVD mortality (HR, 1.73; 95% CI, 1.31-2.29) and incidence (HR, 1.93; 95% CI, 1.78-2.11); and
  • lower risk for cancer mortality (HR, 0.56; 95% CI, 0.39-0.80) and incidence (HR, 0.77; 95% CI, 0.67-0.89).
• Europeans and South Asians with T2D vs those without were at an increased risk for:
  • all-cause mortality (HR, 1.77 [95% CI, 1.68-1.87] and HR, 2.36 [95% CI, 1.62-3.45]),
  • CVD mortality (HR, 2.36 [95% CI, 2.13-2.61] and HR, 3.88 [95% CI, 2.16-6.97]) and incidence (HR, 1.58 [95% CI, 1.52-1.64] and HR, 1.63 [95% CI, 1.33-1.97]), respectively.
• The magnitude of the risk was higher in South Asians than Europeans.

Limitations

• Diagnosis of T2D was based on self-reporting of physician-diagnosed T2D.