Ethnic Differences in the Prevalence of Type 2 Diabetes Diagnoses in the UK: Cross-Sectional Analysis of the Health Improvement Network Primary Care Database.

Tra My Pham, James R Carpenter, Tim P Morris, Manuj Sharma, Irene Petersen

Journal: Clinical epidemiology 2019;11():1081-1088

PMID: 32021464

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Plain Language Summary

Type 2 diabetes mellitus is associated with substantial disease burden, including increased mortality risk and significant long-term morbidity. The aim of this study was to examine the prevalence of type 2 diabetes diagnoses based on primary care electronic health records. This study is a cross-sectional analysis of health records data from The Health Improvement Network primary care database. The sample comprised 51% women; most of the individuals in the sample (approximately 80%) were below 60 years of age. Results show that compared with those of White ethnicity, the likelihood of having a type 2 diabetes diagnosis was more than double among Asian people, 65% more likely among Black people, and 17% more likely among people of Mixed/Other ethnicity. Authors conclude that accurate estimates of ethnic prevalence of type 2 diabetes are important for ensuring that public health resources are allocated appropriately for diabetes screening and lifestyle interventions.

Abstract

AIMS/HYPOTHESIS

Type 2 diabetes mellitus is associated with high levels of disease burden, including increased mortality risk and significant long-term morbidity. The prevalence of diabetes differs substantially among ethnic groups. We examined the prevalence of type 2 diabetes diagnoses in the UK primary care setting.

METHODS

We analysed data from 404,318 individuals in The Health Improvement Network database, aged 0-99 years and permanently registered with general practices in London. The association between ethnicity and the prevalence of type 2 diabetes diagnoses in 2013 was estimated using a logistic regression model, adjusting for effect of age group, sex, and social deprivation. A multiple imputation approach utilising population-level information about ethnicity from the UK census was used for imputing missing data.

RESULTS

Compared with those of White ethnicity (5.04%, 95% CI 4.95 to 5.13), the crude percentage prevalence of type 2 diabetes was higher in the Asian (7.69%, 95% CI 7.46 to 7.92) and Black (5.58%, 95% CI 5.35 to 5.81) ethnic groups, while lower in the Mixed/Other group (3.42%, 95% CI 3.19 to 3.66). After adjusting for differences in age group, sex, and social deprivation, all minority ethnic groups were more likely to have a diagnosis of type 2 diabetes compared with the White group (OR Asian versus White 2.36, 95% CI 2.26 to 2.47; OR Black versus White 1.65, 95% CI 1.56 to 1.73; OR Mixed/Other versus White 1.17, 95% CI 1.08 to 1.27).

CONCLUSION

The prevalence of type 2 diabetes was higher in the Asian and Black ethnic groups, compared with the White group. Accurate estimates of ethnic prevalence of type 2 diabetes based on large datasets are important for facilitating appropriate allocation of public health resources, and for allowing population-level research to be undertaken examining disease trajectories among minority ethnic groups, that might help reduce inequalities.

Address: MRC Clinical Trials Unit at UCL, London WC1V 6LJ, UK.; Department of Primary Care and Population Health, University College London, London NW3 2PF, UK.; MRC Clinical Trials Unit at UCL, London WC1V 6LJ, UK.; Department of Medical Statistics, London School of Hygiene & Tropical Medicines, London WC1E 7HT, UK.; MRC Clinical Trials Unit at UCL, London WC1V 6LJ, UK.; Department of Primary Care and Population Health, University College London, London NW3 2PF, UK.; Department of Primary Care and Population Health, University College London, London NW3 2PF, UK.; Department of Clinical Epidemiology, Aarhus University, Aarhus N 8200, Denmark.

DOI: 10.2147/CLEP.S227621