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Diabetes in the South Asian Populations - Book Report/Review Example

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Epidemiological research suggests that the prevalence of type 2 diabetes in South Asian populations is higher than that seen in other ethnic groups. (DECODA, 2003) Diabetes presents at a relatively earlier age and a lower BMI in this ethnic group.(2006) South Asian patients with type 2 diabetes in the UK have a higher cardiovascular risk and present with cardiovascular events at a significantly younger age than white Europeans.(2010) This review will provide an analysis of the available literature on the epidemiology of diabetes in South Asian populations.
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Download file to see previous pages The immigrants were identified by probabilistically linking the RPD with the Landed Immigrants Database which also contained information on education level, immigration category, age, sex and date of birth. The people who had been diagnosed with diabetes on or before 31st March 2005 were identified using the Ontario Diabetes Database; a validated administrative data registry updated using hospital and physician records. The postal codes of the subjects were linked to area level income from the 2006 Canadian Census, due to the unavailability of individual income data. Logistic regression was used to associate risk factors with the prevalence of diabetes. Risk factors included age, sex, level of education and world region of birth. After controlling for age, time since arrival, education level and immigration category, it was found that the prevalence of diabetes was significantly higher in immigrants from South Asia compared with those from Western and Eastern Europe and North America. Lower income levels were associated with a higher prevalence of diabetes and so was the time since arrival. (The prevalence of diabetes was significantly higher among those living in Canada for 15 years or more compared to those living in Canada for 5-9 years) A limitation of the study is the use of administrative data which only represents diagnosed diabetes. Thus it is possible that the prevalence of diabetes was underestimated in the study. It is also possible for the probability of diagnosis to differ with the country of origin and immigration status. A further limitation is the failure to distinguish between type 1 and type 2 diabetes.
There are several hypotheses explaining the high prevalence of diabetes in South Asian populations. One of these is the thrifty phenotype hypothesis which links intrauterine growth retardation and catch up growth in early infancy to a higher risk in developing diabetes. (Stocker CJ et al., 2005) Conversely the thrifty genotype hypothesis refers to the metabolic adaptation to store adipose tissue as a survival advantage in circumstances of famine. (Neel, 1962) However several studies conducted to investigate its validity including a study by Southam et al. have revealed that there is no conclusive confirmation of the thrifty gene hypothesis. (2009) The role of lifestyle factors cannot be ignored when discussing the higher prevalence of diabetes in South Asians. The health survey of England has identified that Indians, Pakistanis and Bangladeshis are respectively 14%, 30% and 45% less likely to meet current guidelines for physical activity than the general population. (2004)

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