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Review
. 2013 Apr;1281(1):64-91.
doi: 10.1111/nyas.12098.

Type 2 diabetes in East Asians: similarities and differences with populations in Europe and the United States

Ronald C W Ma  1 , Juliana C N Chan
Affiliations
Free PMC article
Review

Type 2 diabetes in East Asians: similarities and differences with populations in Europe and the United States

Ronald C W Ma et al. Ann N Y Acad Sci. 2013 Apr.
Free PMC article

Abstract

There is an epidemic of diabetes in Asia. Type 2 diabetes develops in East Asian patients at a lower mean body mass index (BMI) compared with those of European descent. At any given BMI, East Asians have a greater amount of body fat and a tendency to visceral adiposity. In Asian patients, diabetes develops at a younger age and is characterized by early β cell dysfunction in the setting of insulin resistance, with many requiring early insulin treatment. The increasing proportion of young-onset and childhood type 2 diabetes is posing a particular threat, with these patients being at increased risk of developing diabetic complications. East Asian patients with type 2 diabetes have a higher risk of developing renal complications than Europeans and, with regard to cardiovascular complications, a predisposition for developing strokes. In addition to cardiovascular-renal disease, cancer is emerging as the other main cause of mortality. While more research is needed to explain these interethnic differences, urgent and concerted actions are needed to raise awareness, facilitate early diagnosis, and encourage preventive strategies to combat these growing disease burdens.

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Figures

Figure 1
Figure 1
Relationship between BMI and diabetes prevalence in different ethnicities from the DECODA Study compared to a European population. Adapted with permission.
Figure 2
Figure 2
Comparison of effect sizes of type 2 diabetes risk in East Asians and Europeans for 53 confirmed single nucleotide polymorphisms. Effect size estimates, odds ratio (OR), were obtained from the East Asian genome-wide association (GWA) meta-analysis,, whenever applicable, and from published meta-analyses in European populations., For a few loci, no corresponding data are available in other populations as yet. Locus marked with an asterisk (*) identifies the locus first identified in East Asian populations. Locus marked with # refers to a locus identified from an analysis including parent-of-origin effects.
Figure 3
Figure 3
Pathogenesis of type 2 diabetes.
Figure 4
Figure 4
Social determinants of type 2 diabetes. Reproduced with permission from Whiting et al.
Figure 5
Figure 5
Pathogenetic pathways leading to diabetic cardio–renal complications. Adapted from Ref. .
See this image and copyright information in PMC

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