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
. 2013 Sep;36(9):2670-6.
doi: 10.2337/dc12-2105. Epub 2013 May 1.

Cardiovascular complications and mortality after diabetes diagnosis for South Asian and Chinese patients: a population-based cohort study

Baiju R Shah  1 , J Charles Victor, Maria Chiu, Jack V Tu, Sonia S Anand, Peter C Austin, Douglas G Manuel, Janet E Hux
Affiliations

Cardiovascular complications and mortality after diabetes diagnosis for South Asian and Chinese patients: a population-based cohort study

Baiju R Shah et al. Diabetes Care. 2013 Sep.

Abstract

Objective: Many non-European ethnic groups have an increased risk for diabetes; however, the published literature demonstrates considerable uncertainty about the rates of diabetes complications among minority populations. The objective of this study was to determine the risks of cardiovascular complications and of mortality after diabetes diagnosis for South Asian and Chinese patients, compared with European patients.

Research design and methods: A population-based cohort study identified all 491,243 adults with newly diagnosed diabetes in Ontario, Canada, between April 2002 and March 2009. Subjects were followed until March 2011 for the first occurrence of any cardiovascular complication of diabetes (coronary artery disease, stroke, or lower-extremity amputation) and for all-cause mortality. Median follow-up was 4.7 years.

Results: The crude incidence of cardiovascular complications after diabetes diagnosis was 17.9 per 1,000 patient-years among European patients, 12.0 among South Asian patients, and 7.7 among Chinese patients. After adjusting for baseline characteristics, the cause-specific hazard ratios (HRs) for cardiovascular complications relative to European patients were 0.95 (95% CI 0.90-1.00; P = 0.056) and 0.50 (0.46-0.53; P < 0.001) for South Asian and Chinese patients, respectively. Mortality was lower for both minority groups (adjusted HR for South Asian patients 0.56 [95% CI 0.52-0.60]; P < 0.001; for Chinese patients 0.58 [0.55-0.62]; P < 0.001).

Conclusions: Chinese patients were at substantially lower risk than European patients for cardiovascular complications after diabetes diagnosis, whereas South Asian patients were at comparable risk. Mortality after diabetes diagnosis was markedly lower for both minority populations.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Incidences of cardiovascular complications after diabetes diagnosis for European, South Asian, and Chinese patients, stratified by socioeconomic status.
See this image and copyright information in PMC

Comment in

References

    1. Yusuf S, Hawken S, Ôunpuu S, et al. INTERHEART Study Investigators Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364:937–952 - PubMed
    1. Creatore MI, Moineddin R, Booth G, et al. Age- and sex-related prevalence of diabetes mellitus among immigrants to Ontario, Canada. CMAJ 2010;182:781–789 - PMC - PubMed
    1. Chiu M, Austin PC, Manuel DG, Shah BR, Tu JV. Deriving ethnic-specific BMI cutoff points for assessing diabetes risk. Diabetes Care 2011;34:1741–1748 - PMC - PubMed
    1. Khan NA, Wang H, Anand S, et al. Ethnicity and sex affect diabetes incidence and outcomes. Diabetes Care 2011;34:96–101 - PMC - PubMed
    1. Karter AJ, Ferrara A, Liu JY, Moffet HH, Ackerson LM, Selby JV. Ethnic disparities in diabetic complications in an insured population. JAMA 2002;287:2519–2527 - PubMed

Publication types