Advertisement

Internal and Emergency Medicine

, Volume 11, Issue 3, pp 327–340 | Cite as

Disparities in type 2 diabetes prevalence among ethnic minority groups resident in Europe: a systematic review and meta-analysis

  • Karlijn A. C. MeeksEmail author
  • Deivisson Freitas-Da-Silva
  • Adebowale Adeyemo
  • Erik J. A. J. Beune
  • Pietro A. Modesti
  • Karien Stronks
  • Mohammad H. Zafarmand
  • Charles Agyemang
IM - REVIEW
Part of the following topical collections:
  1. Focus on healthcare and non-communicable disease in migrants

Abstract

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.

Keywords

Type 2 diabetes Prevalence Ethnic minority groups IDF geographical regions Meta-analysis 

Notes

Acknowledgments

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.

Informed consent

None.

References

  1. 1.
    Wild S, Roglic G, Green A, Sicree R, King H (2004) Global prevalence of diabetes estimates for the year 2000 and projections for 2030. Diabetes Care 27(5):1047–1053CrossRefPubMedGoogle Scholar
  2. 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
  3. 3.
    Imkampe AK, Gulliford MC (2011) Increasing socio-economic inequality in type 2 diabetes prevalence–repeated cross-sectional surveys in England 1994–2006. Eur J Pub Health 21(4):484–490. doi: 10.1093/eurpub/ckq106 CrossRefGoogle Scholar
  4. 4.
    Whiting DR, Guariguata L, Weil C, Shaw J (2011) IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 94(3):311–321CrossRefPubMedGoogle Scholar
  5. 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
  6. 6.
    Uitewaal P, Manna D, Bruijnzeels M, Hoes A, Thomas S (2004) Prevalence of type 2 diabetes mellitus, other cardiovascular risk factors, and cardiovascular disease in Turkish and Moroccan immigrants in North West Europe: a systematic review. Prev Med 39(6):1068–1076CrossRefPubMedGoogle Scholar
  7. 7.
    Lanzieri G (2011) Fewer, older and multicultural? Projections of the EU populations by foreign/national background (trans: Eurostat)Google Scholar
  8. 8.
    Oldroyd J, Banerjee M, Heald A, Cruickshank K (2005) Diabetes and ethnic minorities. Postgrad Med J 81(958):486–490CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Seidell JC (2000) Obesity, insulin resistance and diabetes—a worldwide epidemic. Br J Nutr 83(S1):S5–S8CrossRefPubMedGoogle Scholar
  10. 10.
    Whitty CJ, Brunner EJ, Shipley MJ, Hemingway H, Marmot MG (1999) Differences in biological risk factors for cardiovascular disease between three ethnic groups in the Whitehall II study. Atherosclerosis 142(2):279–286CrossRefPubMedGoogle Scholar
  11. 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
  12. 12.
    Cappuccio FP, Cook DG, Atkinson RW, Strazzullo P (1997) Prevalence, detection, and management of cardiovascular risk factors in different ethnic groups in south London. Heart 78(6):555–563CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Gadd M, Sundquist J, Johansson SE, Wandell P (2005) Do immigrants have an increased prevalence of unhealthy behaviours and risk factors for coronary heart disease? Eur J Cardiovasc Prev Rehabil 12(6):535–541CrossRefPubMedGoogle Scholar
  14. 14.
    Jenum AK, Holme I, Graff-Iversen S, Birkeland KI (2005) Ethnicity and sex are strong determinants of diabetes in an urban Western society: implications for prevention. Diabetologia 48(3):435–439. doi: 10.1007/s00125-005-1668-8. CrossRefPubMedGoogle Scholar
  15. 15.
    Tran AT, Straand J, Diep LM, Meyer HE, Birkeland KI, Jenum AK (2011) Cardiovascular disease by diabetes status in five ethnic minority groups compared to ethnic Norwegians. BMC Public Health 11:554. doi: 10.1186/1471-2458-11-554. CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Ujcic-Voortman JK, Schram MT, Jacobs-van der Bruggen MA, Verhoeff AP, Baan CA (2009) Diabetes prevalence and risk factors among ethnic minorities. Eur J Public Health 19(5):511–515. doi: 10.1093/eurpub/ckp096. CrossRefPubMedGoogle Scholar
  17. 17.
    Wandell PE, Hjorleifsdottir Steiner K, Johansson SE (2003) Diabetes mellitus in Turkish immigrants in Sweden. Diabetes Metab 29(4 Pt 1):435–439CrossRefPubMedGoogle Scholar
  18. 18.
    Zaninotto P, Mindell J, Hirani V (2007) Prevalence of cardiovascular risk factors among ethnic groups: results from the Health Surveys for England. Atherosclerosis 195(1):e48–e57. doi: 10.1016/j.atherosclerosis.2007.02.017. CrossRefPubMedGoogle Scholar
  19. 19.
    Abouzeid M, Philpot B, Janus ED, Coates MJ, Dunbar JA (2013) Type 2 diabetes prevalence varies by socio-economic status within and between migrant groups: analysis and implications for Australia. BMC Public Health 13(1):252CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Cauchi S, El Achhab Y, Choquet H, Dina C, Krempler F, Weitgasser R, Nejjari C, Patsch W, Chikri M, Meyre D (2007) TCF7L2 is reproducibly associated with type 2 diabetes in various ethnic groups: a global meta-analysis. J Mol Med 85(7):777–782CrossRefPubMedGoogle Scholar
  21. 21.
    Hu FB (2011) Globalization of Diabetes: the role of diet, lifestyle, and genes. Diabetes Care 34(6):1249–1257. doi: 10.2337/dc11-0442. CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    McNeely MJ, Boyko EJ (2004) Type 2 diabetes prevalence in Asian Americans results of a national health survey. Diabetes Care 27(1):66–69CrossRefPubMedGoogle Scholar
  23. 23.
    Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151(4):264–269CrossRefPubMedGoogle Scholar
  24. 24.
    Roberts A, Cash TF, Feingold A, Johnson BT (2006) Are black-white differences in females’ body dissatisfaction decreasing? A meta-analytic review. J Consult Clin Psychol 74(6):1121CrossRefPubMedGoogle Scholar
  25. 25.
    Carlsson AC, Wandell PE, Hedlund E, Walldius G, Nordqvist T, Jungner I, Hammar N (2013) Country of birth-specific and gender differences in prevalence of diabetes in Sweden. Diabetes Res Clin Pract 100(3):404–408. doi: 10.1016/j.diabres.2013.03.014. CrossRefPubMedGoogle Scholar
  26. 26.
    Agyemang C, Kunst AE, Bhopal R, Anujuo K, Zaninotto P, Nazroo J, Nicolaou M, Unwin N, van Valkengoed I, Redekop WK (2011) Diabetes prevalence in populations of South Asian Indian and African origins: a comparison of England and the Netherlands. Epidemiology 22(4):563–567CrossRefPubMedGoogle Scholar
  27. 27.
    Meeks K, Beune E, Snijder M, Peters R, Stronks K, Agyemang C (2014) Type II diabetes among Ghanaian residents in the Netherlands; how do they compare with other ethnic groups? The HELIUS study. Diabetes Res Clin Pract 103:S2CrossRefGoogle Scholar
  28. 28.
    Weijers RN, Bekedam DJ, Oosting H (1998) The prevalence of type 2 diabetes and gestational diabetes mellitus in an inner city multi-ethnic population. Eur J Epidemiol 14(7):693–699CrossRefPubMedGoogle Scholar
  29. 29.
    Kristensen JK, Bak JF, Wittrup I, Lauritzen T (2007) Diabetes prevalence and quality of diabetes care among Lebanese or Turkish immigrants compared to a native Danish population. Primary Care Diabetes 1(3):159–165. doi: 10.1016/j.pcd.2007.07.007. CrossRefPubMedGoogle Scholar
  30. 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
  31. 31.
    Riste L, Khan F, Cruickshank K (2001) High prevalence of type 2 diabetes in all ethnic groups, including Europeans, in a British inner city: relative poverty, history, inactivity, or 21st century Europe? Diabetes Care 24(8):1377–1383CrossRefPubMedGoogle Scholar
  32. 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. 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
  34. 34.
    Davies MJ, Ammari F, Sherriff C, Burden ML, Gujral J, Burden AC (1999) Screening for Type 2 diabetes mellitus in the UK Indo-Asian population. Diabetic Med 16(2):131–137CrossRefPubMedGoogle Scholar
  35. 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. 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
  37. 37.
    Carulli L, Rondinella S, Lombardini S, Canedi I, Loria P, Carulli N (2005) Review article: diabetes, genetics and ethnicity. Aliment Pharmacol Ther 22:16–19. doi: 10.1111/j.1365-2036.2005.02588.x. CrossRefPubMedGoogle Scholar
  38. 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
  39. 39.
    Lee MM, Wu-Williams A, Whittemore AS, Zheng S, Gallagher R, Teh C-Z, Zhou L, Wang X, Chen K, Ling C (1994) Comparison of dietary habits, physical activity and body size among Chinese in North America and China. Int J Epidemiol 23(5):984–990CrossRefPubMedGoogle Scholar
  40. 40.
    Renzaho AMN, Burns C (2006) Post-migration food habits of sub-Saharan African migrants in Victoria: a cross-sectional study. Nutr Diet 63(2):91–102. doi: 10.1111/j.1747-0080.2006.00055.x. CrossRefGoogle Scholar
  41. 41.
    Shamshirgaran SM, Jorm L, Bambrick H, Hennessy A (2013) Independent roles of country of birth and socioeconomic status in the occurrence of type 2 diabetes. BMC Public Health 13(1):1223CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Shai I, Jiang R, Manson JE, Stampfer MJ, Willett WC, Colditz GA, Hu FB (2006) Ethnicity, obesity, and risk of Type 2 diabetes in women: a 20-year follow-up study. Diabetes Care 29(7):1585–1590. doi: 10.2337/dc06-0057. CrossRefPubMedGoogle Scholar
  43. 43.
    Oza-Frank R, Ali MK, Vaccarino V, Narayan KV (2009) Asian Americans: diabetes prevalence across US and World Health Organization weight classifications. Diabetes Care 32(9):1644–1646CrossRefPubMedPubMedCentralGoogle Scholar
  44. 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. 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

Copyright information

© SIMI 2015

Authors and Affiliations

  • Karlijn A. C. Meeks
    • 1
    Email author
  • Deivisson Freitas-Da-Silva
    • 1
  • Adebowale Adeyemo
    • 2
  • Erik J. A. J. Beune
    • 1
  • Pietro A. Modesti
    • 3
  • Karien Stronks
    • 1
  • Mohammad H. Zafarmand
    • 1
  • Charles Agyemang
    • 1
  1. 1.Department of Public Health, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Center for Research on Genomics and Global Health, National Human Genome Research InstituteNational Institutes of HealthBethesdaUSA
  3. 3.Department of Clinical and Experimental MedicineUniversity of FlorenceFlorenceItaly

Personalised recommendations