Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Aug;58(8):1732-8.
doi: 10.2337/db08-1685. Epub 2009 Mar 3.

Diabetes incidence based on linkages with health plans: the multiethnic cohort

Gertraud Maskarinec  1 , Eva Erber, Andrew Grandinetti, Martijn Verheus, Robert Oum, Beth N Hopping, Mark M Schmidt, Aileen Uchida, Deborah Taira Juarez, Krista Hodges, Laurence N Kolonel
Affiliations

Diabetes incidence based on linkages with health plans: the multiethnic cohort

Gertraud Maskarinec et al. Diabetes. 2009 Aug.

Abstract

Objective: Using the Hawaii component of the Multiethnic Cohort (MEC), we estimated diabetes incidence among Caucasians, Japanese Americans, and Native Hawaiians.

Research design and methods: After excluding subjects who reported diabetes at baseline or had missing values, 93,860 cohort members were part of this analysis. New case subjects were identified through a follow-up questionnaire (1999-2000), a medication questionnaire (2003-2006), and linkage with two major health plans (2007). We computed age-standardized incidence rates and estimated hazard ratios (HRs) for ethnicity, BMI, education, and combined effects of these variables using Cox regression analysis.

Results: After a total follow-up time of 1,119,224 person-years, 11,838 incident diabetic case subjects were identified with an annual incidence rate of 10.4 per 1,000 person-years. Native Hawaiians had the highest rate with 15.5, followed by Japanese Americans with 12.5, and Caucasians with 5.8 per 1,000 person-years; the adjusted HRs were 2.65 for Japanese Americans and 1.93 for Native Hawaiians. BMI was positively related to incidence in all ethnic groups. Compared with the lowest category, the respective HRs for BMIs of 22.0-24.9, 25.0-29.9, and > or =30.0 kg/m(2) were 2.10, 4.12, and 9.48. However, the risk was highest for Japanese Americans and intermediate for Native Hawaiians in each BMI category. Educational achievement showed an inverse association with diabetes risk, but the protective effect was limited to Caucasians.

Conclusions: Within this multiethnic population, diabetes incidence was twofold higher in Japanese Americans and Native Hawaiians than in Caucasians. The significant interaction of ethnicity with BMI and education suggests ethnic differences in diabetes etiology.

PubMed Disclaimer

Figures

FIG. 1.
FIG. 1.
Incident diabetic case subjects (N = 11,838) identified at different follow-up periods within the Hawaii component of the MEC. *Number of subjects provided to BCBS; health plan membership not established for noncase subjects.
FIG. 2.
FIG. 2.
Diabetes risk by ethnicity and BMI. Data are HRs and 95% CIs from the Cox regression analysis (adjusted for age, sex, and education). Caucasians with a BMI <22 kg/m2 are the reference category.
FIG. 3.
FIG. 3.
Influence of education on diabetes incidence by ethnicity. Data are HRs and 95% CIs from the Cox regression analysis (adjusted for age, sex, and BMI). Caucasians with <13 years of education are the reference category.
See this image and copyright information in PMC

References

    1. Sloan NR: Ethnic distribution of diabetes mellitus in Hawaii. JAMA 1963; 183: 419– 424 - PubMed
    1. Centers for Disease Control and Prevention Detailed data for prevalence of diabetes [article online], 2007. Available from http://www.cdc.gov/diabetes/statistics/prev/national/menuraceethsexage.htm Accessed 24 October 2008
    1. McNeely MJ, Boyko EJ: Type 2 diabetes prevalence in Asian Americans: results of a national health survey. Diabetes Care 2004; 27: 66– 69 - PubMed
    1. Maskarinec G, Takata Y, Pagano I, Carlin L, Goodman MT, Le ML, Nomura AM, Wilkens LR, Kolonel LN: Trends and dietary determinants of overweight and obesity in a multiethnic population. Obesity (Silver Spring) 2006; 14: 717– 726 - PubMed
    1. Grandinetti A, Kaholokula JK, Theriault AG, Mor JM, Chang HK, Waslien C: Prevalence of diabetes and glucose intolerance in an ethnically diverse rural community of Hawaii. Ethn Dis 2007; 17: 250– 255 - PubMed

Publication types