TY - JOUR
T1 - Ethnic differences in metabolic achievement between Māori, Pacific, and European New Zealanders with type 2 diabetes
AU - Yu, Dahai
AU - Cai, Yamei
AU - Osuagwu, Uchechukwu Levi
AU - Pickering, Karen
AU - Baker, John
AU - Cutfield, Richard
AU - Jansen, Rawiri McKree
AU - Orr-Walker, Brandon J.
AU - Sundborn, Gerhard
AU - Zhao, Zhanzheng
AU - Simmons, David
PY - 2022
Y1 - 2022
N2 - Aims: To compare variations in metabolic target achievement by ethnicity (Europeans, Māori and Pasifika) among patients with type 2 diabetes (T2DM) in Auckland, New Zealand (NZ) between 1994-2013. Methods: 32,237 patients were enrolled. Adjusted marginal difference (European as reference) of systolic blood pressure (SBP), body mass index (BMI), HbA1c and total cholesterol, alongside the proportion achieving metabolic targets were estimated using multivariable mixed effect models at baseline, 1-, 2-, 3-, 4-, and 5-years, adjusted for covariates. Results: Compared with Europeans, Māori and Pasifika had continuously, significantly higher HbA1c (by 0.3% (+3.5mmol/mol) and 0.6% (+6.8 mmol/mol) respectively and BMI (+1.5 and +0.3 kg/m2 respectively) but lower SBP (-1.8 and -3.4 mmHg respectively) and TG (-0.03 and -0.34 mmol/L respectively), and insignificantly TC (+0.004 and +0.01 respectively), by 5-year of follow-up. While 49% Europeans were within target HbA1c, this was achieved by only 30% Māori and 27% Pasifika. Conversely, 41% Europeans, 46% Māori and 59% Pasifika achieved the SBP target (all P<0.0001). Conclusions: Managing hyperglycemia appears to be more challenging than treating hypertension and dyslipidemia in these ethnic groups. New anti-hyperglycemia treatments, addressing health literacy, socioeconomic and any cultural barriers to management and self-management are urgently needed to reduce these disparities.
AB - Aims: To compare variations in metabolic target achievement by ethnicity (Europeans, Māori and Pasifika) among patients with type 2 diabetes (T2DM) in Auckland, New Zealand (NZ) between 1994-2013. Methods: 32,237 patients were enrolled. Adjusted marginal difference (European as reference) of systolic blood pressure (SBP), body mass index (BMI), HbA1c and total cholesterol, alongside the proportion achieving metabolic targets were estimated using multivariable mixed effect models at baseline, 1-, 2-, 3-, 4-, and 5-years, adjusted for covariates. Results: Compared with Europeans, Māori and Pasifika had continuously, significantly higher HbA1c (by 0.3% (+3.5mmol/mol) and 0.6% (+6.8 mmol/mol) respectively and BMI (+1.5 and +0.3 kg/m2 respectively) but lower SBP (-1.8 and -3.4 mmHg respectively) and TG (-0.03 and -0.34 mmol/L respectively), and insignificantly TC (+0.004 and +0.01 respectively), by 5-year of follow-up. While 49% Europeans were within target HbA1c, this was achieved by only 30% Māori and 27% Pasifika. Conversely, 41% Europeans, 46% Māori and 59% Pasifika achieved the SBP target (all P<0.0001). Conclusions: Managing hyperglycemia appears to be more challenging than treating hypertension and dyslipidemia in these ethnic groups. New anti-hyperglycemia treatments, addressing health literacy, socioeconomic and any cultural barriers to management and self-management are urgently needed to reduce these disparities.
UR - http://hdl.handle.net/1959.7/uws:64308
U2 - 10.1016/j.diabres.2022.109910
DO - 10.1016/j.diabres.2022.109910
M3 - Article
VL - 189
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 109910
ER -
