Characteristics and prognosis of A sian patients with type 2 diabetes from a multi‐racial A ustralian community: the F remantle D iabetes S tudy

Background A sian migrants represent an expanding proportion of the A ustralian population and are from a region with an increasing diabetes burden. There are few data detailing the characteristics and outcome of type 2 diabetes in A sian A ustralians. Aims To determine whether the phenotype and prognosis of A sians with type 2 diabetes differ from those in A nglo‐ C elt ( AC ) patients from the same A ustralian community. Methods We studied 44 A sian and 796 AC patients from the F remantle D iabetes S tudy. Each had a detailed assessment between 1993 and 1996, and was invited to annual reviews for ≥5 years. Data linkage provided additional endpoints to end‐2010. Cox proportional hazards modelling was used to determine predictors of cardiovascular disease ( CVD ) death and all‐cause mortality. Results The prevalence of type 2 diabetes in A sians and the general population in F remantle was similar (1.5% vs 1.6%; P = 0.60). The A sian patients were younger, less obese and less likely to be hypertensive than the AC subjects, but they had a higher retinopathy prevalence (27.3% vs 13.5%; P = 0.023). During up to 18 years of follow up, 12 Asians and 428 AC patients died, 2 (16.7%) vs 205 (47.9%) from CVD ( P = 0.040). Asian ethnicity was independently protective against CVD death (hazard ratio 0.13 (95% confidence interval: 0.02–0.96); P = 0.046) but not all‐cause mortality (hazard ratio 0.58 ( 95% confidence interval: 0.31–1.10); P = 0.10). Conclusions The phenotype of type 2 diabetes in a relatively small group of well‐characterised A sian A ustralians differed from that in AC patients from the same urban community. Their favourable cardiovascular prognosis may reflect a healthy migrant effect.