title: Cardiovascular complications and mortality after diabetes diagnosis for South Asian and Chinese patients: a population-based cohort study.
abstract: OBJECTIVE
  Many non-European ethnic groups have an increased risk for diabetes; however, the published literature demonstrates considerable uncertainty about the rates of diabetes complications among minority populations. The objective of this study was to determine the risks of cardiovascular complications and of mortality after diabetes diagnosis for South Asian and Chinese patients, compared with European patients.
  
  
  METHODS
  A population-based cohort study identified all 491,243 adults with newly diagnosed diabetes in Ontario, Canada, between April 2002 and March 2009. Subjects were followed until March 2011 for the first occurrence of any cardiovascular complication of diabetes (coronary artery disease, stroke, or lower-extremity amputation) and for all-cause mortality. Median follow-up was 4.7 years.
  
  
  RESULTS
  The crude incidence of cardiovascular complications after diabetes diagnosis was 17.9 per 1,000 patient-years among European patients, 12.0 among South Asian patients, and 7.7 among Chinese patients. After adjusting for baseline characteristics, the cause-specific hazard ratios (HRs) for cardiovascular complications relative to European patients were 0.95 (95% CI 0.90-1.00; P = 0.056) and 0.50 (0.46-0.53; P < 0.001) for South Asian and Chinese patients, respectively. Mortality was lower for both minority groups (adjusted HR for South Asian patients 0.56 [95% CI 0.52-0.60]; P < 0.001; for Chinese patients 0.58 [0.55-0.62]; P < 0.001).
  
  
  CONCLUSIONS
  Chinese patients were at substantially lower risk than European patients for cardiovascular complications after diabetes diagnosis, whereas South Asian patients were at comparable risk. Mortality after diabetes diagnosis was markedly lower for both minority populations.
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. baiju.shah@ices.on.ca
authors: Baiju R
authors: BR
authors: Shah
authors: J Charles
authors: JC
authors: Victor
authors: Maria
authors: M
authors: Chiu
authors: Jack V
authors: JV
authors: Tu
authors: Sonia S
authors: SS
authors: Anand
authors: Peter C
authors: PC
authors: Austin
authors: Douglas G
authors: DG
authors: Manuel
authors: Janet E
authors: JE
authors: Hux
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001208:Asia / Q000453:epidemiology; D044466:Asian People; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044465:White People; D055815:Young Adult
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