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Cardiovascular complications and mortality after diabetes diagnosis for South Asian and Chinese patients: a population-based cohort study.

Abstract：

OBJECTIVE:Many non-European ethnic groups have an increased risk for diabetes; however, the published literature demonstrates considerable uncertainty about the rates of diabetes complications among minority populations. The objective of this study was to determine the risks of cardiovascular complications and of mortality after diabetes diagnosis for South Asian and Chinese patients, compared with European patients. RESEARCH DESIGN AND METHODS:A population-based cohort study identified all 491,243 adults with newly diagnosed diabetes in Ontario, Canada, between April 2002 and March 2009. Subjects were followed until March 2011 for the first occurrence of any cardiovascular complication of diabetes (coronary artery disease, stroke, or lower-extremity amputation) and for all-cause mortality. Median follow-up was 4.7 years. RESULTS:The crude incidence of cardiovascular complications after diabetes diagnosis was 17.9 per 1,000 patient-years among European patients, 12.0 among South Asian patients, and 7.7 among Chinese patients. After adjusting for baseline characteristics, the cause-specific hazard ratios (HRs) for cardiovascular complications relative to European patients were 0.95 (95% CI 0.90-1.00; P = 0.056) and 0.50 (0.46-0.53; P < 0.001) for South Asian and Chinese patients, respectively. Mortality was lower for both minority groups (adjusted HR for South Asian patients 0.56 [95% CI 0.52-0.60]; P < 0.001; for Chinese patients 0.58 [0.55-0.62]; P < 0.001). CONCLUSIONS:Chinese patients were at substantially lower risk than European patients for cardiovascular complications after diabetes diagnosis, whereas South Asian patients were at comparable risk. Mortality after diabetes diagnosis was markedly lower for both minority populations.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Shah BR,Victor JC,Chiu M,Tu JV,Anand SS,Austin PC,Manuel DG,Hux JE

doi

10.2337/dc12-2105

subject

Has Abstract

pub_date

2013-09-01 00:00:00

pages

2670-6

issue

eissn

0149-5992

issn

1935-5548

pii

dc12-2105

journal_volume

pub_type

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Cardiovascular complications and mortality after diabetes diagnosis for South Asian and Chinese patients: a population-based cohort study.