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Disparities in type 2 diabetes prevalence among ethnic minority groups resident in Europe: a systematic review and meta-analysis

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Abstract

Many ethnic minorities in Europe have a higher type 2 diabetes (T2D) prevalence than their host European populations. The risk size differs between ethnic groups, but the extent of the differences in the various ethnic minority groups has not yet been systematically quantified. We conducted a meta-analysis of published data on T2D in various ethnic minority populations resident in Europe compared to their host European populations. We systematically searched MEDLINE (using PUBMED) and EMBASE for papers on T2D prevalence in ethnic minorities in Europe published between 1994 and 2014. The ethnic minority groups were classified into five population groups by geographical origin: South Asian (SA), Sub-Saharan African (SSA), Middle Eastern and North African (MENA), South and Central American (SCA), and Western Pacific (WP). Pooled odds ratios with corresponding 95 % confidence interval (CI) were calculated using Review Manager 5.3. Twenty articles were included in the analysis. Compared with the host populations, SA origin populations had the highest odds for T2D (3.7, 95 % CI 2.7–5.1), followed by MENA (2.7, 95 % CI 1.8–3.9), SSA (2.6, 95 % CI 2.0–3.5), WP (2.3, 95 % CI 1.2–4.1), and lastly SCA (1.3, 95 % CI 1.1–1.6). Odds ratios were in all ethnic minority populations higher for women than for men except for SCA. Among SA subgroups, compared with Europeans, Bangladeshi had the highest odds ratio of 6.2 (95 % CI 3.9–9.8), followed by Pakistani (5.4, 95 % CI 3.2–9.3) and Indians (4.1, 95 % CI 3.0–5.7). The risk of T2D among ethnic minority groups living in Europe compared to Europeans varies by geographical origin of the group: three to five times higher among SA, two to four times higher among MENA, and two to three times higher among SSA origin. Future research and policy initiatives on T2D among ethnic minority groups should take the interethnic differences into account.

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Acknowledgments

We acknowledge the support received from Science Without Borders (SWG-122/2012) Brazil, for the work of D. Freitas-Da-Silva.

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Correspondence to Karlijn A. C. Meeks.

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Appendix: Search terms used in MEDLINE

Appendix: Search terms used in MEDLINE

Ethnic minority groups

ethnic group[tiab] OR group, ethnic[MeSh Terms] OR nationality*[tiab] OR ethnicity[tiab] OR race[tiab] OR racial stock[tiab] OR migrant*[tiab] OR ethnic minority group[tiab] OR non-western migrants[tiab] OR african*[tiab] OR north african*[tiab] OR arab[tiab] OR arabs[tiab] OR arabic[tiab] OR african*[tiab] OR west african*[tiab] OR black[tiab] OR black african*[tiab] OR south sahara african*[tiab] OR moroccan*[tiab] OR somali*[tiab] OR ethiopian*[tiab] OR sudanese*[tiab] OR ghanaian*[tiab] OR sub-sahara african*[tiab] OR afro-arab*[tiab] OR maghrebin*[tiab] OR harki*[tiab] OR asian*[tiab] OR south asian*[tiab] OR east asian*[tiab] OR middle east asian*[tiab] OR turkish*[tiab] OR turk*[tiab] OR indian*[tiab] OR pakistani*[tiab] OR bangladeshi*[tiab] OR palestinian*[tiab] OR syrian*[tiab] OR lebanese*[tiab] OR yemeni*[tiab] OR egyptian*[tiab] OR iraqi*[tiab] OR jordanian*[tiab] OR vietnamese*[tiab] OR iranian*[tiab] OR kurd*[tiab] OR chinese*[tiab] OR japanese*[tiab] OR jew*[tiab] OR muslim*[tiab] OR sri lankan*[tiab] OR oceanian*[tiab] OR oceanic*[tiab] OR australian*[tiab] OR new zealander*[tiab] OR kiwi*[tiab] OR indonesian*[tiab] OR north american*[tiab] OR central american*[tiab] OR south american*[tiab] OR hispanic*[tiab] OR Caribbean*[tiab] OR african caribbean*[tiab] OR african-caribbean*[tiab] OR white caribbean*[tiab] OR black caribbean*[tiab] OR surinamese*[tiab] OR surinaam*[tiab] OR antillean*[tiab] OR aruban*[tiab] OR mexican*[tiab] OR mexican–american*[tiab] OR chilean*[tiab] OR argentinian*[tiab] OR american*[tiab] OR canadian*[tiab] OR brazilian*[tiab] OR us american*[tiab] OR inuit*[tiab] OR asian caribbean*[tiab] OR african caribbean*[tiab] OR african-caribbean*[tiab]

Europe

europe OR southern europe OR western europe OR northern europe OR albania OR andorra OR armenia OR austria OR azerbaijan OR belarus OR belgium OR bosnia and herzegovina OR bulgaria OR croatia OR cyprus OR czech republic OR denmark OR estonia OR finland OR france OR georgia OR germany OR greece OR hungary OR iceland OR ireland OR italy OR kosovo OR latvia OR liechtenstein OR lithuania OR luxembourg OR macedonia OR malta OR moldova OR monaco OR montenegro OR netherlands OR norway OR poland OR portugal OR romania OR russia OR san marino OR serbia OR slovakia OR slovenia OR spain OR sweden OR switzerland OR the former yugoslav republic of macedonia OR turkey OR ukraine OR united kingdom 

Type 2 diabetes

diabetes[tiab] OR diabetes mellitus[tiab] OR noninsulin-dependent diabetes mellitus[tiab] OR niddm[tiab] OR type 2 diabetes mellitus[tiab] OR oral glucose tolerance test[tiab] OR ogtt[tiab] OR venous plasma glucose[tiab] OR fasting glucose[tiab]

Prevalence data

vital statistics OR vital statistics registration OR morbidity OR prevalence[mesh] OR prevalence [tw] OR epidemiology[sh] OR epidemiologic studies[mesh terms] NOT (case–control study OR case–control studies OR seroepidemiologic study OR seroepidemiologic studies)

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Meeks, K.A.C., Freitas-Da-Silva, D., Adeyemo, A. et al. Disparities in type 2 diabetes prevalence among ethnic minority groups resident in Europe: a systematic review and meta-analysis. Intern Emerg Med 11, 327–340 (2016). https://doi.org/10.1007/s11739-015-1302-9

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