Changes in characteristics and management of A sian and A nglo‐ C elts with type 2 diabetes over a 15‐year period in an urban A ustralian community: The F remantle D iabetes S tudy

Background The aim of the present study was to determine temporal changes in characteristics and management of A sians with type 2 diabetes ( T 2 D ) compared with those of the majority A nglo‐ C elt ( AC ) patients in an urban Australian community. Methods Cross‐sectional data from the observational F remantle D iabetes S tudy ( FDS ) collected in 1993–96 ( P hase I ; FDS 1) and 2008–11 ( P hase II ; FDS 2) were analyzed for patients classified as A sian ( n  = 44 and 65 in FDS 1 and FDS2, respectively) or AC ( n  = 796 and 793, respectively). Between‐group differences in changes in key variables between FDS phases were analyzed by generalized linear modeling with adjustment for age and gender. Results A sians patients were significantly younger at diagnosis and recruitment and had a lower body mass index and smaller waist circumference than the AC participants in both FDS phases. They were also less likely to be treated for hypertension. Cardiovascular risk factors and their management and macrovascular complications were similar in the two groups over time. A greater propensity to retinopathy with A sian ethnicity in FDS 1 (27.3% vs 13.5%; P  = 0.23) was attenuated in FDS 2 (23.7% vs 19.0%; P  = 0.39). A sians had a significantly lower prevalence of peripheral sensory neuropathy in FDS2 (33.8% vs 63.3%; P  < 0.001; adjusted P  = 0.011 for between‐group temporal change). Conclusions There were persistent differences between the phenotypic features of A sian migrants with T 2 D versus AC patients in an Australian urban community over 15 years of follow‐up, but management of diabetes and non‐glycemic risk factors remained comparable. Ethnicity‐specific differences in susceptibility to microvascular complications should be considered in clinical management.