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Diabetes, smoking and LABAs

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Diabetes in ethnic minorities
Diabetes Care (2012) doi:10.2337/dc12-0544

Abdominal (truncal) obesity and insulin resistance account for the increased risk of type 2 diabetes mellitus (T2DM) among Indian-Asian and African-Caribbean women, according to the SABRE (Southall and Brent Revisited) study. The causes of the increased risk among men remain 'unclear"'

SABRE enrolled 1356 Europeans, 842 Indian Asians and 335 African Caribbeans aged 40 to 69 years. During the 20-year follow-up, 14 per cent of Europeans, 33 per cent of Indian Asians and 30 per cent of African Caribbeans developed T2DM. Diabetes was roughly twice as common in men and women of Indian-Asian (age-adjusted subhazard ratios [SHRs] 2.88 and 1.91 respectively) and African-Caribbean descent (2.23 and 2.51) compared to Europeans.

Baseline truncal skinfold was 0.6, 2.4 and 1.4 cm greater in European, Indian-Asian and African-Caribbean women respectively than men of the same ethnicity. Baseline differences in truncal obesity and insulin resistance accounted for the excess risk of diabetes associated with ethnic background among Indian-Asian and African-Caribbean women. In contrast, T2DM risk remained roughly doubled after adjusting for truncal obesity and insulin resistance among Indian-Asian (SHR 1.98) and African-Caribbean (SHR 2.05) men. So, the reason for the increased risk of diabetes in ethnic minority men 'remains unclear'.

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