Ethnic differences in prediabetes and diabetes in the Suriname Health Study

Abstract

BackgroundDiabetes is increasing worldwide, and information on risk factors to develop targeted interventions is limited. Therefore, we analyzed data of the Suriname Health Study to estimate the prevalence of prediabetes and diabetes. We also explored whether ethnic differences in prediabetes or diabetes risk could be explained by biological, demographic, lifestyle, anthropometric, and metabolic risk factors.MethodThe study was designed according to the WHO Steps guidelines. Fasting blood glucose levels were measured in 3393 respondents, aged 15–65 years, from an Amerindian, Creole, Hindustani, Javanese, Maroon or Mixed ethnic background. Prediabetes was defined by fasting blood glucose levels between 6.1 and 7.0 mmol/L and diabetes by fasting blood glucose levels ≥7.0 mmol/L or ‘self-reported diabetes medication use.’ For all ethnicities, we analyzed sex, age, marital status, educational level, income status, employment, smoking status, residence, physical activity, body mass index, waist circumference, hypertension, and the levels of triglyceride, total cholesterol, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol.ResultsThe prevalence of prediabetes was 7.4%, while that of diabetes was 13 0%. From these diabetes cases, 39.6% were not diagnosed previously. No ethnic differences were observed in the prevalence of prediabetes. For diabetes, Hindustanis (23.3%) had twice the prevalence compared to other ethnic groups (4.7–14.2%). The associations of the risk factors with prediabetes or diabetes varied among the ethnic groups. The differences in the associations of ethnic groups with prediabetes or diabetes were partly explained by these risk factors.ConclusionsThe prevalence of diabetes in Suriname is high and most elevated in Hindustanis. The observed variations in risk factors among ethnic groups might explain the ethnic differences between these groups, but follow-up studies are needed to explore this in more depth.

Ethnic disparities in the prevalence of metabolic syndrome and its risk factors in the Suriname Health Study: a cross-sectional population study

“…The higher prevalences, found among the Amerindians, Hindustanis and Javanese, are in line with published findings on MetS components from the Suriname Health Study 19. These findings also concur with the higher prevalences reported in the Mexicans and Hispanics in the USA 33…”

“…In each of these ethnic groups, cardiovascular disease and diabetes are the main causes of morbidity and mortality 1718 Data from the Suriname Health Study on pre-diabetes and diabetes showed a prevalence of 13% for diabetes overall and of 23.3% in the Hindustanis 1920 The MetS components described in this analysis indicated the highest median values for central obesity in the Amerindians and Hindustanis, the highest mean systolic blood pressure values in the Creoles and the mean values for blood glucose and blood lipids most approaching deviating values in the Javanese and Hindustanis 19.…”

Metabolic Syndrome in Indigenous Amerindian Women in Suriname; Less on Waist and More on Weight?

“…Both diabetes mellitus and hypertension were less prevalent than the national average for women (resp. 13% and 20%) [22][23]. The relatively high prevalence of Me TS found in both study groups coupled with the relatively low prevalence of hypertension and diabetes mellitus could be an indication that both these subpopulations are in epidemiological transition [2,24], though at different stages.…”

Development and Validation of a New Diabetes Risk Score in Guyana

“…Another limitation is the inclusion of only a small number of people of Amerindian descent. Ethnic differences in risk factors for diabetes have been shown in neighbouring Suriname [16] with an absence of an association with BMI in Amerindians. Other studies have shown a lower rate of diabetes in Amerindians in remote villages [17] but higher rates associated with increased biological risk factors in urban settings [18].…”