Ethnic differences in Glycaemic control in people with type 2 diabetes mellitus living in Scotland

Background and Aims: Previous studies have investigated the association between ethnicity and processes of care and intermediate outcomes of diabetes, but there are limited population-based studies available. The aim of this study was to use population-based data to investigate the relationships between ethnicity and glycaemic control in men and women with diabetes mellitus living in Scotland.<p></p> Methods: We used a 2008 extract from the population-based national electronic diabetes database of Scotland. The association between ethnicity with mean glycaemic control in type 2 diabetes mellitus was examined in a retrospective cohort study, including adjustment for a number of variables including age, sex, socioeconomic status, body mass index (BMI), prescribed treatment and duration of diabetes.<p></p> Results: Complete data for analyses were available for 56,333 White Scottish adults, 2,535 Pakistanis, 857 Indians, 427 Chinese and 223 African-Caribbeans. All other ethnic groups had significantly (p<0.05) greater proportions of people with suboptimal glycaemic control (HbA1c >58 mmol/mol, 7.5%) compared to the White Scottish group, despite generally younger mean age and lower BMI. Fully adjusted odds ratios for suboptimal glycaemic control were significantly higher among Pakistanis and Indians (1.85, 95% CI: 1.68–2.04, and 1.62,95% CI: 1.38–1.89) respectively.<p></p> Conclusions: Pakistanis and Indians with type 2 diabetes mellitus were more likely to have suboptimal glycaemic control than the white Scottish population. Further research on health services and self-management are needed to understand the association between ethnicity and glycaemic control to address ethnic disparities in glycaemic control.<p></p&gt

Proportion of people with Type 2 DM in Scotland having optimal glycaemic control (mean HbA1c cut-off 58 mmol/mol, 7.5%) for demographic and clinical variables (n = 56713).

<p>All associations between each variable and proportion of optimal mean glycaemic control was statistically significant (p<0.001)</p

Flow chart showing inclusion and exclusion of cases for analysis.

<p>Flow chart showing inclusion and exclusion of cases for analysis.</p

Crude and adjusted odds ratios for suboptimal glycaemic control (mean HbA1c >58 mmol/mol, 7.5%) compared to the white Scottish population (n = 56713).

<p>Adjusted variables - sex, age socioeconomic status (SES), BMI, prescribed treatment and duration</p

Comparison of demographic and clinical variables among ethnic groups with Type 2 DM living in Scotland (n = 56713).

<p>For each minority ethnic group, differences in all variables showed statistically significant association (p<0.01) compared to the Scottish group unless stated otherwise.</p><p>^ap = 0.13 for comparison between White Scottish and African-Caribbean; p = 0.12 for comparison between White Scottish and Pakistani; p = 0.07 for comparison between White Scottish and Chinese;</p><p>^bat time of data extraction;</p><p>^cmean of all available BMIs for each person.</p