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Dina Mansour Aly

Research student

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Adult-onset diabetes in Middle Eastern immigrants to Sweden : Novel subgroups and diabetic complications—The All New Diabetes in Scania cohort diabetic complications and ethnicity

Author

  • Louise Bennet
  • Christopher Nilsson
  • Dina Mansour-Aly
  • Anders Christensson
  • Leif Groop
  • Emma Ahlqvist

Summary, in English

Background: Middle Eastern immigrants to Europe represent a high risk population for type 2 diabetes. We compared prevalence of novel subgroups and assessed risk of diabetic macro- and microvascular complications between diabetes patients of Middle Eastern and European origin. Methods: This study included newly diagnosed diabetes patients born in Sweden (N = 10641) or Iraq (N = 286), previously included in the All New Diabetes in Scania cohort. The study was conducted between January 2008 and August 2016. Patients were followed to April 2017. Incidence rates in diabetic macro- and microvascular complications were assessed using cox-regression adjusting for the confounding effect of age at onset, sex, anthropometrics, glomerular filtration rate (eGFR) and HbA1c. Findings: In Iraqi immigrants versus native Swedes, severe insulin-deficient diabetes was almost twice as common (27.9 vs. 16.2% p < 0.001) but severe insulin-resistant diabetes was less prevalent. Patients born in Iraq had higher risk of coronary events (hazard ratio [HR] 1.84, 95% CI 1.06–3.12) but considerably lower risk of chronic kidney disease (CKD) than Swedes (HR 0.19; 0.05–0.76). The lower risk in Iraqi immigrants was partially attributed to better eGFR. Genetic risk scores (GRS) showed more genetic variants associated with poor insulin secretion but lower risk of insulin resistance in the Iraqi than native Swedish group. Interpretation: People with diabetes, born in the Middle East present with a more insulin-deficient phenotype and genotype than native Swedes. They have a higher risk of coronary events but lower risk of CKD. Ethnic differences should be considered in the preventive work towards diabetes and its complications.

Department/s

  • Family Medicine and Community Medicine
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • Genomics, Diabetes and Endocrinology
  • Internal Medicine - Epidemiology

Publishing year

2021

Language

English

Publication/Series

Diabetes/Metabolism Research and Reviews

Volume

37

Issue

6

Document type

Journal article

Publisher

John Wiley and Sons

Topic

  • Endocrinology and Diabetes
  • Public Health, Global Health, Social Medicine and Epidemiology

Keywords

  • ethnicity
  • GRS
  • macrovascular diabetic complications
  • microvascular diabetic complications
  • novel subgroups of diabetes
  • SIDD
  • SIRD

Status

Published

Research group

  • Family Medicine and Community Medicine
  • Genomics, Diabetes and Endocrinology
  • Internal Medicine - Epidemiology

ISBN/ISSN/Other

  • ISSN: 1520-7552