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October 31, 2013Diabetic Medicine

Ethnicity and long‐term vascular outcomes in Type 2 diabetes: a prospective observational study (UKPDS 83)

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Why the study?

Does ethnicity affect the risk of long-term vascular outcomes and mortality in individuals with newly diagnosed Type 2 diabetes?

Population

4,273 individuals with newly diagnosed Type 2 diabetes from the UK Prospective Diabetes Study, including…

Comparison

Afro-Caribbean and Asian Indian ethnicity vs White Caucasian ethnicity

Design

Cohort

Follow-up

median 18 years

Authors

TDTimothy M. E. DavisRCRuth L. ColemanRHRury R. Holman

Discussion

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Member takes

Overview

Ethnic differences may refine T2D risk models; extends prior cohorts but leaves causal pathways and interventions open.

Key Points

  • To examine the relationship between ethnicity and long-term vascular outcomes and mortality in a large cohort of individuals with newly diagnosed type 2 diabetes.
  • Analyzed 4,273 UK Prospective Diabetes Study participants (3,543 White Caucasian, 312 Afro-Caribbean, and 418 Asian Indian) followed prospectively for a median of 18 years.
  • Used accelerated failure time models adjusted for cardiovascular risk factors and confounding variables to estimate relative risks comparing ethnic groups.
  • Asian Indian participants had a higher risk for any diabetes-related endpoint (RR 1.18, 95% CI 1.07–1.29), but a lower risk of all-cause mortality (RR 0.89, 95% CI 0.80–0.97) and peripheral vascular disease (RR 0.43, 95% CI 0.23–0.82) compared to White Caucasians.
  • Afro-Caribbean participants experienced lower risks for all-cause mortality (RR 0.84, 95% CI 0.76–0.93), diabetes-related death (RR 0.75, 95% CI 0.64–0.88), myocardial infarction (RR 0.55, 95% CI 0.43–0.71), and peripheral vascular disease (RR 0.55, 95% CI 0.33–0.93) compared to White Caucasians.
  • Overall, 2,468 (58%) participants developed a diabetes-related endpoint, 1,037 (24%) had a myocardial infarction, 401 (9%) had a stroke, and 1,782 (42%) died, with no ethnic differences observed for stroke or microangiopathy.

Structured PICO

Does ethnicity affect the risk of long-term vascular outcomes and mortality in individuals with newly diagnosed Type 2 diabetes?

P
Population
4,273 individuals with newly diagnosed Type 2 diabetes from the UK Prospective Diabetes Study, including 3,543 (83%) White Caucasian, 312 (7%) Afro-Caribbean, and 418 (10%) Asian Indian participants.
I
Intervention
Afro-Caribbean and Asian Indian ethnicity
C
Comparator
White Caucasian ethnicity
O
Outcome
Predefined outcomes including any diabetes-related end point, myocardial infarction, stroke, all-cause mortality, diabetes-related death, peripheral vascular disease, and microangiopathy at median 18 years follow-uphard clinical

In newly diagnosed Type 2 diabetes, Afro-Caribbean and Asian Indian ethnicities are associated with lower risks of all-cause mortality and certain vascular complications compared to White Caucasians.

Cite This Study

Davis et al. (2013) studied this question.

synapsesocial.com/papers/6a836c8301fa249fc1dfa9fdhttps://doi.org/10.1111/dme.12353
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Premature cardiovascular events and mortality in south Asians with type 2 diabetes in the United Kingdom Asian Diabetes Study – effect of ethnicity on risk2010 · 94 citations
  2. 2Cardiovascular events and mortality in people with and without type 2 diabetes: An observational study in a contemporary multi‐ethnic population2020 · 45 citations
  3. 3Ethnicity and Cardiovascular Disease: The incidence of myocardial infarction in white, South Asian, and Afro-Caribbean patients with type 2 diabetes (U.K. Prospective Diabetes Study 32)1998 · 87 citations
  4. 4Ethnicity and prognosis following a cardiovascular event in people with and without type 2 diabetes: Observational analysis in over 5 million subjects in England2022 · 7 citations
  5. 5Ethnic differences in mortality from cardiovascular disease in the UK: do they persist in people with diabetes?1996 · 111 citations