Metabolic and clinical characteristics of south Asians and Europeans in Coventry

Abstract

A house to house survey in Foleshill, Coventry, compared risk factors for Type 2 diabetes and ischaemic heart disease (IHD) among adult United Kingdom Europeans (n = 5508, 64% screened) and South Asians (n = 4395, 84% screened). Those with a high glucose and a randomized 10% of others had a glucose tolerance test while those with previously diagnosed diabetes (104 Europeans, 223 South Asians) were re-interviewed in more detail. By the age of 29 years, South Asians had higher 2 h glucose 5.4 +/- 1.0 vs 4.84 +/- 1.2 mmol l-1, p < 0.005) and insulin (45.6 vs 23.8 mU l-1, p < 0.001) concentrations and in males, a higher cholesterol concentration (5.1 +/- 0.9 vs 4.6 +/- 1.2 mmol l-1, p < 0.05). South Asians with known Type 2 diabetes had an earlier age at diagnosis (48 +/- 11 vs 57 +/- 14 years, p < 0.001), a lower body mass index in the past (29.0 +/- 4.8 vs 32.1 +/- 6.9 kg m-2, p < 0.001) and currently (27.1 +/- 3.7 vs 29.1 +/- 6.4 kg m-2, p < 0.001), were more likely to present with acute symptoms, were less likely to attend the hospital clinic (14% vs 31%, p < 0.001), and were less likely to be treated with diet alone (14% vs 21%) or with insulin (9% vs 16%) than Europeans. Glycaemic control was similar in the two ethnic groups. These findings suggest an earlier onset of the disease processes involved in diabetes in South Asians. Important ethnic differences in patterns of care exist that make clinical comparisons difficult.