Cardiovascular and Mortality Risks in Migrant South Asians with Type 2 Diabetes: Are We Winning the Battle?

Abstract

Purpose of review: We seek to describe the relationship between diabetes mellitus and cardiovascular risk in migrant South Asians compared to native white Europeans, and to determine the temporal change in this relationship over recent years.

Recent findings: Recent evidence suggests that the excess mortality risk associated with diabetes is lower in the migrant South Asian population compared with white Europeans. By contrast, South Asians continue to demonstrate elevated cardiovascular morbidity compared to white Europeans, although to a lesser extent than was observed in previous decades. The excess mortality previously observed in South Asian migrants has attenuated with a lower mortality risk compared to white Europeans observed in several recent studies. We speculate that these findings may relate in part to earlier diabetes diagnosis and more prolonged exposure to cardiovascular risk factor management in the South Asian population. Further study is required to confirm these hypotheses.

Keywords: Cardiovascular risk; Diabetes mellitus; South Asian; Type 2 diabetes mellitus.

Fig. 1

Relative risk of mortality in migrant South Asians with diabetes versus white Europeans reported in papers spanning the last 3–4 decades. All relevant studies discussed in the text [, , , –, ••]. IHD ischaemic heart disease

Fig. 2

Speculated mechanisms for changing cardiovascular mortality risks in migrant South Asians with diabetes relative to white Europeans. Several proposed mechanisms require confirmation from future studies