Ethnicity and prevalence of diabetic complications in elderly patients

The objective of this study was to assess whether ethnicity plays a role in the prevalence of diabetic complications in elderly patients.

Data were collected by prospective computerised audit on 834 diabetic patients in a district general hospital in South Buckinghamshire, UK. The patients were aged over 60 and of different ethnic backgrounds: 692 Caucasians (C), 60 Afro‐Caribbeans/Africans (A) and 82 South Asians (SA). Mean HbA_1c, microalbuminuria, retinopathy and treated hypertension were analysed and compared.

The results showed that mean (SD) HbA_1c was 8.8% (1.9%) for the C group and 8.6% (2.1%) for the SA group, but was higher in the A group (9.3% [2.1%]) (p=0.034 vs C; p=0.044 vs SA). Microalbuminuria (>15mg albumin/12 hours) was not statistically different in the C and A groups (102 [14.7%] vs 11 [18.3%]), but was higher in the SA group (19 [23.2%]) (p=0.050 vs C). Retinopathy (identified by an ophthalmologist at the retinal screening clinic) was found in 254 (36.7%) of the C group, in 24 (40.0%) of the A group and less frequently in the SA group (21 [25.6%], p=0.063 vs A; p=0.054 vs C). Hypertension (patients currently taking antihypertensive medication) was found in 282 (40.8%) of the C group, more frequently in the A group (34 [56.7%], p=0.022) and less frequently in the SA group (24 [29.3%], p<0.001 vs A; p=0.049 vs C).

In conclusion, glycaemic control was worst in the A group. Retinopathy and hypertension were most frequent in the A group. The SA group had a lower prevalence of retinopathy and treated hypertension; however, they had a higher prevalence of microalbuminuria. The frequency of diabetic complications was different between ethnic groups, particularly group A. These differences may be the result of antecedent glycaemic control, hypertension or ethnicity. Copyright © 2004 John Wiley & Sons, Ltd.