Adult Arabs have higher risk for diabetes mellitus than Jews in Israel

<div><p>Objective</p><p>Diabetes mellitus is an emerging epidemic in the Arab world. Although high diabetes prevalence is documented in Israeli Arabs, information from cohort studies is scant.</p><p>Methods</p><p>This is a population study, based on information derived between 2007–2011, from the electronic database of the largest health fund in Israel, among Arabs and Jews. Prevalence, 4-year-incidence and diabetes hazard ratios [HRs], adjusted for sex and the metabolic-syndrome [MetS]-components, were determined in 3 age groups (<50 years, 50–59 years, and ≥60 years).</p><p>Results</p><p>The study cohort included 17,044 Arabs (males: 49%, age: 39.4±17.3) and 16,012 Jews (males: 50%, age: 40.5 ±17.6). The overall age and sex-adjusted diabetes prevalence rates were much higher among Arabs 18.4% (95%CI: 17.6–19.1); and 10.3% (95%CI: 9.7–10.9) among Jews. Arab females had higher prevalence rates 20.0% (95%CI: 19–21) than Arab males 16.7% (95%CI: 15.7–17.8). Annual incidence rates were also significantly higher among Arabs 2.9% (95%CI: 2.7–3.1) than among Jews 1.7% (95%CI: 1.6–1.8). This held true across all age and sex subgroups. Adjustment for body mass index [BMI] attenuated HR estimates associated with Arab ethnicity across all age subgroups, mainly in the <50yrs age group from HR 2.04 (95%CI: 1.74–2.40) to 1.64 (95%CI: 1.40–1.92). BMI at incident diabetes among females was higher in Arabs than Jews. Males, however, did not differ by ethnicity.</p><p>Conclusion</p><p>Arabs, mainly female, have high incidence and prevalence of diabetes. This excess risk is only partially explained by the high prevalence of obesity. Effective culturally-congruent diabetes prevention and treatment and an effective engagement partnership with the Arab community are of paramount need.</p></div

Baseline characteristics of the study cohort.

<p>Baseline characteristics of the study cohort.</p

Standardized and age-specific prevalence and weighted cumulative 4-yr incidence per 100 persons of diabetes (95% confidence interval)^*.

<p>Standardized and age-specific prevalence and weighted cumulative 4-yr incidence per 100 persons of diabetes (95% confidence interval)^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0176661#t002fn002" target="_blank">*</a>}.</p

Standardized and age-specific prevalence and weighted average annual incidence per 100 persons of diabetes (95% confidence interval)^* over the period of 2008–11.

<p>Standardized and age-specific prevalence and weighted average annual incidence per 100 persons of diabetes (95% confidence interval)^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0157354#t002fn002" target="_blank">*</a>} over the period of 2008–11.</p

Baseline characteristics of the study cohort.

<p>Baseline characteristics of the study cohort.</p

Cox proportional hazard ratios (95% confidence interval) for incident diabetes by ethnicity, age, sex and components of the metabolic syndrome^*.

<p>Cox proportional hazard ratios (95% confidence interval) for incident diabetes by ethnicity, age, sex and components of the metabolic syndrome^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0176661#t003fn001" target="_blank">*</a>}.</p

BMI among patients with incident diabetes and healthy controls by ethnicity and age^*.

<p>BMI among patients with <u>incident</u> diabetes and healthy controls by ethnicity and age^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0176661#t004fn001" target="_blank">*</a>}.</p

Cox proportional hazard ratios (95% confidence interval) for incident diabetes by ethnicity, age, sex and components of the metabolic syndrome^*.

<p>Cox proportional hazard ratios (95% confidence interval) for incident diabetes by ethnicity, age, sex and components of the metabolic syndrome^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0157354#t003fn001" target="_blank">*</a>}.</p