Ethnicity is an independent risk indicator when estimating diabetes risk with FINDRISC scores: a cross sectional study comparing immigrants from the Middle East and native Swedes.
OBJECTIVE
This study sought to compare type 2 diabetes (T2D) risk indicators in Iraqi immigrants with those in ethnic Swedes living in southern Sweden.


METHODS
Population-based, cross-sectional cohort study of men and women, aged 30-75 years, born in Iraq or Sweden conducted in 2010-2012 in Malmö, Sweden. A 75g oral glucose tolerance test was performed and sociodemographic and lifestyle data were collected. T2D risk was assessed by the Finnish Diabetes Risk Score (FINDRISC).


RESULTS
In Iraqi versus Swedish participants, T2D was twice as prevalent (11.6 vs. 5.8%, p<0.001). A large proportion of the excess T2D risk was attributable to larger waist circumference and first-degree family history of diabetes. However, Iraqi ethnicity was a risk factor for T2D independently of other FINDRISC factors (odds ratio (OR) 2.5, 95% CI 1.6-3.9). The FINDRISC algorithm predicted that more Iraqis than Swedes (16.2 vs. 12.3%, p<0.001) will develop T2D within the next decade. The total annual costs for excess T2D risk in Iraqis are estimated to exceed 2.3 million euros in 2005, not accounting for worse quality of life.


CONCLUSIONS
Our study suggests that Middle Eastern ethnicity should be considered an independent risk indicator for diabetes. Accordingly, the implementation of culturally tailored prevention programs may be warranted.
Department of Clinical Sciences, Lund University, Malmö, Sweden; Family Medicine, Lund University, Malmö, Sweden. Electronic address: louise.bennet@med.lu.se.
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Bennet
Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Diabetes and Endocrinology/Lund Diabetes Centre, Skåne University Hospital, Malmö, Sweden.
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Groop
Department of Primary Health Care, Institute of Medicine, University of Gothenburg, Sweden.
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Lindblad
Department of Clinical Sciences, Lund University, Malmö, Sweden.
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Agardh
Department of Clinical Sciences, Lund University, Malmö, Sweden; Genetic & Molecular Epidemiology Unit, Lund University, Malmö, Sweden; Department of Nutrition, Harvard School of Public Health, Boston Massachusetts, USA; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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Franks
D000328:Adult; D000368:Aged; D000465:Algorithms; D018912:Arabs; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000191:economics / Q000208:ethnology*; D054242:Emigrants and Immigrants; D005260:Female; D005951:Glucose Tolerance Test; D017048:Health Care Costs; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007493:Iraq / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D044465:White People
FINDRISC; Incidence; Middle East; Prevalence; Type 2 diabetes