title: Disparities in type 2 diabetes prevalence among ethnic minority groups resident in Europe: a systematic review and meta-analysis.
abstract: Many ethnic minorities in Europe have a higher type 2 diabetes (T2D) prevalence than their host European populations. The risk size differs between ethnic groups, but the extent of the differences in the various ethnic minority groups has not yet been systematically quantified. We conducted a meta-analysis of published data on T2D in various ethnic minority populations resident in Europe compared to their host European populations. We systematically searched MEDLINE (using PUBMED) and EMBASE for papers on T2D prevalence in ethnic minorities in Europe published between 1994 and 2014. The ethnic minority groups were classified into five population groups by geographical origin: South Asian (SA), Sub-Saharan African (SSA), Middle Eastern and North African (MENA), South and Central American (SCA), and Western Pacific (WP). Pooled odds ratios with corresponding 95 % confidence interval (CI) were calculated using Review Manager 5.3. Twenty articles were included in the analysis. Compared with the host populations, SA origin populations had the highest odds for T2D (3.7, 95 % CI 2.7-5.1), followed by MENA (2.7, 95 % CI 1.8-3.9), SSA (2.6, 95 % CI 2.0-3.5), WP (2.3, 95 % CI 1.2-4.1), and lastly SCA (1.3, 95 % CI 1.1-1.6). Odds ratios were in all ethnic minority populations higher for women than for men except for SCA. Among SA subgroups, compared with Europeans, Bangladeshi had the highest odds ratio of 6.2 (95 % CI 3.9-9.8), followed by Pakistani (5.4, 95 % CI 3.2-9.3) and Indians (4.1, 95 % CI 3.0-5.7). The risk of T2D among ethnic minority groups living in Europe compared to Europeans varies by geographical origin of the group: three to five times higher among SA, two to four times higher among MENA, and two to three times higher among SSA origin. Future research and policy initiatives on T2D among ethnic minority groups should take the interethnic differences into account.
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands. k.a.meeks@amc.uva.nl.
authors.forename: Karlijn A C
authors.initials: KA
authors.lastname: Meeks
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
authors.forename: Deivisson
authors.initials: D
authors.lastname: Freitas-Da-Silva
authors.affiliation: Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Adebowale
authors.initials: A
authors.lastname: Adeyemo
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
authors.forename: Erik J A J
authors.initials: EJ
authors.lastname: Beune
authors.affiliation: Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
authors.forename: Pietro A
authors.initials: PA
authors.lastname: Modesti
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
authors.forename: Karien
authors.initials: K
authors.lastname: Stronks
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Zafarmand
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
authors.forename: Charles
authors.initials: C
authors.lastname: Agyemang
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000208:ethnology* / Q000628:therapy; D005006:Ethnicity / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data*; D015995:Prevalence; D018570:Risk Assessment
keywords: Ethnic minority groups; IDF geographical regions; Meta-analysis; Prevalence; Type 2 diabetes