A family history of diabetes determines poorer glycaemic control and younger age of diabetes onset in immigrants from the Middle East compared with native Swedes Glycaemic control in Iraqi immigrants

A family history of diabetes determines poorer glycaemic control and younger age of diabetes onset in immigrants from the Middle East compared with native Swedes. General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal ? 1 A family history of diabetes determines poorer glycaemic control and younger age of diabetes onset in immigrants from the Middle East compared with native Swedes Glycaemic control in Iraqi immigrants ANDIS 825-2010-5983). The funders were not involved in the data collection, data analysis, manuscript preparation and/or public decisions. 3 Abstract Aims: Immigrant populations from the Middle East develop diabetes earlier than European indigenous populations; however, the underlying aetiology is poorly understood. The aims were to study risk factors associated with early diabetes onset and, in non-diabetics, to study glycaemic control in immigrants from Iraq and native Swedes. Methods: This cross-sectional population-based study comprised 1,398 Iraqi immigrants and 757 Swedes (age 30-75 years) residing in the same area of Malmö, Sweden. Outcomes were age at diabetes onset and glycaemic control (HbA1c) assessed by Cox proportional hazards and linear regression respectively. Results: In Iraqis versus Swedes, clustering of family history (family history in ≥2 relatives) was more prevalent (23.2 vs. 3.6%, p<0.001) and diabetes onset occurred earlier (47.6 vs. 53.4 years, P=0.001). Iraqi background independently raised the hazards for diabetes onset. Diabetes risk due to family history was augmented by obesity, with the highest hazard ratios observed in obese participants with clustering of family history (hazard ratio 5.1, 95% CI 3.2 to 8.2), after adjustment for country of birth and sex. In participants without previously diagnosed diabetes (Iraqis N=1270; Swedes N=728), HbA1c levels were slightly higher in Iraqis than Swedes (4.5 vs. 4.4%, P=0.038). This difference was explained primarily by clustering of family history, rather than by age, obesity, lifestyle or socioeconomy. Conclusions: This study shows that the greater predispotion to diabetes in Middle Eastern …