title: Differences between Western and Asian type 2 diabetes patients in the incidence of vascular complications and mortality: A systematic review of randomized controlled trials on lowering blood glucose.
abstract: BACKGROUND
  Differences exist between Western and Asian people with type 2 diabetes (T2D). The aim of the present systematic review was to determine whether there are differences in chronic diabetic vascular complications (CDVCs) and mortality between Western and Asian patients with T2D.
  
  
  METHODS
  Three databases (EMBASE, MEDLINE, and Cochrane library) were searched for publications from 1966 to March 2013 describing interventional randomized control trials (RCTs) targeting to lower blood glucose levels. The RCTs included had follow-up durations of at least 4 years as an endpoint or in their initial design, analyzed effects on mortality and/or CDVCs in T2D and compared differences in mortality and/or CDVCs among patients of different ethnicities.
  
  
  RESULTS
  Two studies, including 19 439 patients with advanced diabetes, were eligible for analysis. Patients were divided into those of Western (including Australia and New Zealand) and Asian ethnicities. The incidence of all-cause mortality, cardiovascular death, and major coronary events was significantly higher in Western than Asian patients, whereas the incidence of major cerebrovascular events, microvascular events (except for peripheral neuropathy), new or worsening nephropathy, and retinopathy was significantly lower in Western patients. There were no-between group differences in macrovascular events, including cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke.
  
  
  CONCLUSIONS
  There are differences in CDVCs and mortality rates between Western and Asian patients with advanced T2D, primarily due to ethnicity-specific factors (e.g. different genetic background, lifestyle). Knowledge of these disparities may allow more effective monitoring and management of individual patients based on ethnic differences.
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University.
authors.forename: Yajie
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Chinese Cochrane Center, Chinese Evidence-Based Medicine Center of International Clinical Epidemiology Network (INCLEN), Local Resource and Training Center, Chengdu, China.
authors.forename: Taixiang
authors.initials: T
authors.lastname: Wu
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University. buddyjun@hotmail.com.
authors.forename: Nanwei
authors.initials: N
authors.lastname: Tong
mesh_terms: D044466:Asian People; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000208:ethnology* / Q000401:mortality; D006801:Humans; D015994:Incidence; D016032:Randomized Controlled Trials as Topic; D014652:Vascular Diseases / Q000150:complications / Q000453:epidemiology / Q000208:ethnology*; D044465:White People
chemical_list: D001786:Blood Glucose
keywords: 2型糖尿病; ethnic differences; meta-analysis; meta分析; randomized trials; type 2 diabetes; 种族差异; 随机对照试验