Diabetes cutoffs don’t quite cut it for South Asians

By Sally Robertson, B.Sc.Jul 27 2012

Individuals of South Asian (SA) origin may require closer monitoring for Type 2 diabetes, suggest researchers.

Ethnic-specific cutoff values for blood sugar parameters may be needed for such individuals, they say.

"Our study suggests the main measures of glucose used in diagnosis of Type 2 diabetes are all higher in South Asians independent of risk factors which cause diabetes such as obesity, blood pressure, smoking, and gender," said lead author Samiul Mostafa from the University of Leicester in the UK, in a press statement.

The findings come from an analysis of data from the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care (ADDITION)-Leicester study that compared 4688 White Europeans (WEs) and 1352 SAs.

In an analysis of the independent effect of ethnicity on glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and 2-hour plasma glucose (2hrPG), Mostafa and team found that the parameters were all significantly higher in SAs than in WEs, at respective increases of 0.19%, 0.15 mmol/L, and 0.75 mmol/L.

Measurement of risk factors among the large study population was robust and included adjustment for age, gender, deprivation level, systolic and diastolic blood pressure, creatinine, albumin-to-creatinine ratio, body mass index (BMI), waist circumference, triglycerides, high- and low-density lipoproteins, potassium, FPG, 2hrPG, and finally, fasting insulin.

"The current study is the first to demonstrate this effect persisted after adjusting for factors that may affect glycemia or that differed between these ethnic groups," says the team.

International organizations have recommended using ethnic-specific cut points for SAs in relation to BMI, waist circumference, and the metabolic syndrome, note the researchers. However, there is no suggestion of ethnic-specific cutoff points for diagnosis of diabetes using HbA1c.

The relationship between HbA1c and the onset of diabetes complications between SAs and WEs should be investigated further to determine whether ethnic-specific cut points are required for diabetes diagnosis in SAs, they conclude.

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