Diabetes is classified as either type 1 diabetes or type 2 diabetes. Type 1 diabetes is an autoimmune disorder that results from destruction of insulin secreting beta islet cells of the pancreas. The onset of type 1 diabetes is usually in childhood and patients become insulin dependent. Type 2 diabetes is usually diagnosed in adults. With the growing childhood obesity epidemic, we are beginning to see type 2 diabetes with increasing rates in children as well. Diabetes increases the risk of several chronic medical conditions including heart disease, stroke, kidney failure, peripheral nerve damage, and possibly limb amputation. The incidence of diabetes has continued to rise, and we have previously discussed the finding that the worldwide diabetes rate has more than doubled in the last 30 years.
Researchers, led by Dr. Therese Tillin from Imperial College London, have found that individuals of Asian, African, and African Caribbean descent are more than twice as likely as Caucasian Europeans to develop diabetes by the age of 80 years. In addition, it was found that half of these ethnic minorities will develop diabetes by this age. The results of their research were published online in the journal Diabetes Care. The researchers followed almost 4,200 triethnic participants in The Southall and Brent Revisited (SABRE) cohort for over 20 years. The study participants were evaluated with a lifestyle questionnaire and for fasting and post glucose blood measurements, anthropometry, and incident diabetes. Incident diabetes was diagnosed in 14% of Caucasian Europeans, 33% of Indian Asians, and 30% of African Caribbeans.
The authors wrote, “Indian Asian and African Caribbean migrants to the U.K. haveat least twice the risk of development ofdiabetes compared with British Europeans, even in older age, broadly reflecting patterns observed in younger populations worldwide. Given the increasing life expectancies for those with type 2 diabetes, this presents a public health challenge”.
The authors also wrote, “Measures of insulin resistance and ectopic fat deposition, particularly truncal, account for excess diabetes risk in Indian Asian and African Caribbean womenbut only make a contribution to the excess risk in ethnic minority men. Strikingly,we show that despite our comprehensive measures, the ethnic minority excess of incident diabetes in men (bothIndian Asians and African Caribbeans) cannot be explained, whereas it can be explained for women… better assessment of risk factors and/or a search for novel factors are required if we are to understand why ethnic minority groups are at such high risk for diabetes”.
This is an alarming finding and suggests that this trend will continue in other parts of the world as well. Screening for diabetes should be performed at an earlier age for this population. In addition, preventing the onset of diabetes should be encouraged through weight loss and control, regular exercise, and portion control. This finding has grave implications for the health of future generation because the complications from diabetes are great and carry significant morbidity. Through education and primary care prevention, this trend can be reversed. Future studies should focus on determining the cause of the excess risk in these ethnic minority groups.
Therese Tillin et al. “Insulin Resistance and Truncal Obesity as Important Determinants of the Greater Incidence of Diabetes in Indian Asians and African Caribbeans Compared with Europeans: The Southall and Brent Revisited (SABRE) cohort” Diabetes Care published online before print September 10, 2012 doi: 10.2337/dc12-0544