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Type 2 diabetes associated with lower mortality for South Asians, blacks vs. whites
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Type 2 diabetes is associated with more years of life lost among whites vs. South Asians or blacks, according to an analysis of general practices across the United Kingdom.
“We showed that, compared to whites with type 2 diabetes, South Asians and blacks with type 2 diabetes had lower risks for all-cause mortality, and lower mortality from cardiovascular causes, respiratory causes and cancer,” Martin K. Rutter, MD, FRCP, senior lecturer and honorary consultant physician at the University of Manchester and Manchester Diabetes Centre, told Endocrine Today. “The leading cause of death in patients with diabetes was cardiovascular disease, and therefore, the findings support optimized CVD risk factor management, especially in whites with type 2 diabetes.”
Rutter and colleagues analyzed data from 187,968 patients with type 2 diabetes from 1998 to 2015 (mean age, 62 years; 55% men), matched to 908,016 controls, using records from the Clinical Practice Research Datalink, a database of 383 general practices in England with linked hospitalization and mortality records. Researchers estimated years of life lost with abridged life tables, and used a competing risk survival model to quantify cause-specific HRs.
Among patients with type 2 diabetes, 40,286 deaths occurred. At age 40 years, both men and women with type 2 diabetes experienced loss of several years of life vs. controls (men, 5.4 years; women, 6.3 years). However, according to life expectancy estimates stratified by race, the effect of diabetes was greater in white men and women, according to researchers.
Compared with controls, white men with type 2 diabetes aged 40 years lost 5 years of life; white women with type 2 diabetes aged 40 years lost 6 years. For South Asian and black adults with type 2 diabetes, there was a loss of between 1 and 2 years vs. controls, according to researchers.
At age 65 years and older, South Asians with diabetes had up to 1.1 years’ longer life expectancy vs. South Asians without diabetes. Compared with whites with diabetes, South Asians with diabetes had lower adjusted risks for mortality from CV (HR = 0.82; 95% CI, 0.75–0.89), cancer (HR = 0.43; 95% CI, 0.36–0.51) and respiratory diseases (HR = 0.60; 95% CI, 0.48–0.76). A similar pattern was observed in blacks with diabetes compared with whites with diabetes.
“We were surprised to see that older South Asians experienced longer life-expectancy compared to South Asians without diabetes,” Rutter said. “Further research is needed into the mechanisms underlying these ethnic disparities in type 2 diabetes outcomes, which may in turn guide public health strategies.” – by Regina Schaffer
Disclosure: Rutter reports receiving researcher funding, educational and travel grants from Merck Sharp & Dohme and Novo Nordisk, consultancy arrangements with Cell Catapult and Roche Diagnostics, and owning shares in GlaxoSmithKline.
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