Disparities in type 2 diabetes prevalence among ethnic minority groups resident in Europe: a systematic review and meta-analysis
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Many ethnic minorities in Europe have a higher type 2 diabetes (T2D) prevalence than their host European populations. The risk size differs between ethnic groups, but the extent of the differences in the various ethnic minority groups has not yet been systematically quantified. We conducted a meta-analysis of published data on T2D in various ethnic minority populations resident in Europe compared to their host European populations. We systematically searched MEDLINE (using PUBMED) and EMBASE for papers on T2D prevalence in ethnic minorities in Europe published between 1994 and 2014. The ethnic minority groups were classified into five population groups by geographical origin: South Asian (SA), Sub-Saharan African (SSA), Middle Eastern and North African (MENA), South and Central American (SCA), and Western Pacific (WP). Pooled odds ratios with corresponding 95 % confidence interval (CI) were calculated using Review Manager 5.3. Twenty articles were included in the analysis. Compared with the host populations, SA origin populations had the highest odds for T2D (3.7, 95 % CI 2.7–5.1), followed by MENA (2.7, 95 % CI 1.8–3.9), SSA (2.6, 95 % CI 2.0–3.5), WP (2.3, 95 % CI 1.2–4.1), and lastly SCA (1.3, 95 % CI 1.1–1.6). Odds ratios were in all ethnic minority populations higher for women than for men except for SCA. Among SA subgroups, compared with Europeans, Bangladeshi had the highest odds ratio of 6.2 (95 % CI 3.9–9.8), followed by Pakistani (5.4, 95 % CI 3.2–9.3) and Indians (4.1, 95 % CI 3.0–5.7). The risk of T2D among ethnic minority groups living in Europe compared to Europeans varies by geographical origin of the group: three to five times higher among SA, two to four times higher among MENA, and two to three times higher among SSA origin. Future research and policy initiatives on T2D among ethnic minority groups should take the interethnic differences into account.
KeywordsType 2 diabetes Prevalence Ethnic minority groups IDF geographical regions Meta-analysis
We acknowledge the support received from Science Without Borders (SWG-122/2012) Brazil, for the work of D. Freitas-Da-Silva.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Statement of human and animal rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with human and animals performed by any of the authors.
- 2.Cowie CC, Rust KF, Byrd-Holt DD, Eberhardt MS, Flegal KM, Engelgau MM, Saydah SH, Williams DE, Geiss LS, Gregg EW (2006) Prevalence of diabetes and impaired fasting glucose in adults in the US Population: National Health and Nutrition Examination Survey 1999–2002. Diabetes Care 29(6):1263–1268. doi: 10.2337/dc06-0062 CrossRefPubMedGoogle Scholar
- 5.Agyemang C, Addo J, Bhopal R, de Graft Aikins A, Stronks K (2009) Cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe: a literature review. Glob Health 5(7):1Google Scholar
- 7.Lanzieri G (2011) Fewer, older and multicultural? Projections of the EU populations by foreign/national background (trans: Eurostat)Google Scholar
- 11.Bennet L, Johansson SE, Agardh CD, Groop L, Sundquist J, Rastam L, Sundquist K (2011) High prevalence of type 2 diabetes in Iraqi and Swedish residents in a deprived Swedish neighbourhood–a population based study. BMC Public Health 11:303. doi: 10.1186/1471-2458-11-303. CrossRefPubMedPubMedCentralGoogle Scholar
- 30.Bhopal R, Unwin N, White M, Yallop J, Walker L, Alberti KG, Harland J, Patel S, Ahmad N, Turner C, Watson B, Kaur D, Kulkarni A, Laker M, Tavridou A (1999) Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladeshi, and European origin populations: cross sectional study. BMJ 319(7204):215–220CrossRefPubMedPubMedCentralGoogle Scholar
- 32.Tillin T, Hughes AD, Mayet J, Whincup P, Sattar N, Forouhi NG, McKeigue PM, Chaturvedi N (2013) The relationship between metabolic risk factors and incident cardiovascular disease in Europeans, South Asians, and African Caribbeans: SABRE (Southall and Brent Revisited)—a prospective population-based study. J Am Coll Cardiol 61(17):1777–1786. doi: 10.1016/j.jacc.2012.12.046. CrossRefPubMedPubMedCentralGoogle Scholar
- 33.Webb DR, Gray LJ, Khunti K, Srinivasan B, Taub N, Campbell S, Barnett J, Farooqi A, Echouffo-Tcheugui JB, Griffin SJ, Wareham NJ, Davies MJ (2011) Screening for diabetes using an oral glucose tolerance test within a western multi-ethnic population identifies modifiable cardiovascular risk: the ADDITION-Leicester study. Diabetologia 54(9):2237–2246. doi: 10.1007/s00125-011-2189-2. CrossRefPubMedGoogle Scholar
- 35.Unwin N, Harland J, White M, Bhopal R, Winocour P, Stephenson P, Watson W, Turner C, Alberti KG (1997) Body mass index, waist circumference, waist-hip ratio, and glucose intolerance in Chinese and Europid adults in Newcastle, UK. J Epidemiol Community Health 51(2):160–166CrossRefPubMedPubMedCentralGoogle Scholar
- 36.Kooner JS, Saleheen D, Sim X, Sehmi J, Zhang W, Frossard P, Been LF, Chia K-S, Dimas AS, Hassanali N, Jafar T, Jowett JBM, Li X, Radha V, Rees SD, Takeuchi F, Young R, Aung T, Basit A, Chidambaram M, Das D, Grundberg E, Hedman AK, Hydrie ZI, Islam M, Khor C-C, Kowlessur S, Kristensen MM, Liju S, Lim W-Y, Matthews DR, Liu J, Morris AP, Nica AC, Pinidiyapathirage JM, Prokopenko I, Rasheed A, Samuel M, Shah N, Shera AS, Small KS, Suo C, Wickremasinghe AR, Wong TY, Yang M, Zhang F, Abecasis GR, Barnett AH, Caulfield M, Deloukas P, Frayling TM, Froguel P, Kato N, Katulanda P, Kelly MA, Liang J, Mohan V, Sanghera DK, Scott J, Seielstad M, Zimmet PZ, Elliott P, Teo YY, McCarthy MI, Danesh J, Tai ES, Chambers JC (2011) Genome-wide association study in individuals of South Asian ancestry identifies six new type 2 diabetes susceptibility loci. Nat Genet 43 (10):984–989CrossRefPubMedPubMedCentralGoogle Scholar
- 38.Mbanya J, Cruickshank JK, Forrester T, Balkau B, Ngogang JY, Riste L, Forhan A, Anderson N, Bennett F, Wilks R (1999) Standardized comparison of glucose intolerance in west African-origin populations of rural and urban Cameroon, Jamaica, and Caribbean migrants to Britain. Diabetes Care 22(3):434–440CrossRefPubMedGoogle Scholar
- 44.Agyemang C, Bhopal R (2002) Is the blood pressure of South Asian adults in the UK higher or lower than that in European white adults? A review of cross-sectional data. J Hum Hypertens 16(11):739–51Google Scholar
- 45.Agyemang C, Beune E, Meeks K, Owusu-Dabo E, Agyei-Baffour P, Aikins Ad-G, Dodoo F, Smeeth L, Addo J, Mockenhaupt FP (2015) Rationale and cross-sectional study design of the research on obesity and type 2 Diabetes among African Migrants: the RODAM study. BMJ Open 4(3):e004877. doi: 10.1136/bmjopen-2014-004877. CrossRefGoogle Scholar