Background: The incidence of type 2 diabetes (T2D) is rising worldwide. South Asians are at higher risk, nearly 2-4 times greater than white Europeans, and tend to develop T2D at an earlier age and lower BMI. Prior studies have shown a potential advantage of incretin-based therapies in South Asians. The purpose of this study is to compare baseline characteristics of South Asians with T2D with those of other ethnic groups and to determine whether South Asians have a better glycemic response to incretin-based therapies in an urban United States diabetes center.
Methods: Retrospective chart review of patients with T2D at the University of Maryland Center for Diabetes and Endocrinology from 2010-16 was performed. Adult patients (ages 18-85) with T2DM were included. A total of 43 South Asians (India, Bangladesh, Pakistan, Sri Lanka) and 182 non-South Asians (further subclassified into black or Non-Hispanic white) were enrolled. Data on age of T2DM diagnosis, family history, BMI, diabetic medications, exercise, blood pressure, and presence of micro- or macrovascular complications were collected. Baseline characteristics were compared and tested for statistical significance by Chi-square test and student t-tests.
Results: South Asians were diagnosed with T2D at a lower BMI (29 vs. 34; p<0.0001) compared to their non-south Asian counterparts. In the South Asian group, there was a trend towards lower age at diagnosis, higher incidence of CAD and nephropathy compared to non- South Asians. No differences in hemoglobin A1c between South Asians vs. non-South Asians were noted at 3-month follow-up after initiation of incretin-based therapy.
Conclusion: South Asians are more likely to have T2D at a lower BMI than black or Non-Hispanic white patients in an urban United States setting. No significant difference in T2DM complications was noted among ethnic groups, and incretin-based therapies did not have a significant effect on in South Asians vs. non-South Asians.
A. Ahmed: None. W. Rahman: None. K.M. Munir: None.