title: Elevated incidence of type 2 diabetes in San Antonio, Texas, compared with that of Mexico City, Mexico.
abstract: OBJECTIVE
  To compare the incidence of type 2 diabetes between low-income Mexican-Americans residing in San Antonio, Texas, and low-income residents in Mexico City, Mexico.
  
  
  METHODS
  Using data from the San Antonio Heart Study and the Mexico City Diabetes Study, we compared the incidence of type 2 diabetes in 35- to 64-year-old low-income Mexican-American residents of San Antonio with similarly aged low-income residents of Mexico City. Because of the different follow-up times in the two studies, Poisson regression was used to compare the rates of diabetes. Potential risk factors for diabetes were also analyzed to determine whether they explained or contributed to a difference in incidence.
  
  
  RESULTS
  The age- and sex-adjusted incidence of type 2 diabetes was significantly higher in San Antonio (RR 2.01) compared with Mexico City. This difference was seen primarily in the oldest age group (55-64 years of age) and remained statistically significant after adjusting for a number of diabetes risk factors, including demographic, anthropometric, and metabolic variables. Follow-up rates were similar in both cities.
  
  
  CONCLUSIONS
  We conclude that there was a higher incidence of type 2 diabetes in San Antonio than in Mexico City, and that difference occurred primarily in individuals in the oldest age group. The potential mediating factors we examined did not account for this difference. Other factors, such as exercise and diet, which were not available for analysis in this study, in addition to a cohort effect, may have contributed to the difference in incidence of type 2 diabetes in the two cities. In addition, there was no evidence of a higher case fatality among diabetic individuals from Mexico City compared with San Antonio.
authors.affiliation: Department of Health Sciences Research, Harwick 6, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA. jburke@mayo.edu
authors.forename: J P
authors.initials: JP
authors.lastname: Burke
authors.forename: K
authors.initials: K
authors.lastname: Williams
authors.forename: S M
authors.initials: SM
authors.lastname: Haffner
authors.forename: C G
authors.initials: CG
authors.lastname: Villalpando
authors.forename: M P
authors.initials: MP
authors.lastname: Stern
mesh_terms: D000328:Adult; D017677:Age Distribution; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D003710:Demography; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D007182:Income; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D016012:Poisson Distribution; D011203:Poverty; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D013781:Texas / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood; D014505:Urban Population
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides