title: Ethnic differences in prediabetes and diabetes in the Suriname Health Study.
abstract: BACKGROUND
  Diabetes is increasing worldwide, and information on risk factors to develop targeted interventions is limited. Therefore, we analyzed data of the Suriname Health Study to estimate the prevalence of prediabetes and diabetes. We also explored whether ethnic differences in prediabetes or diabetes risk could be explained by biological, demographic, lifestyle, anthropometric, and metabolic risk factors.
  
  
  METHODS
  The study was designed according to the WHO Steps guidelines. Fasting blood glucose levels were measured in 3393 respondents, aged 15-65 years, from an Amerindian, Creole, Hindustani, Javanese, Maroon or Mixed ethnic background. Prediabetes was defined by fasting blood glucose levels between 6.1 and 7.0 mmol/L and diabetes by fasting blood glucose levels ≥7.0 mmol/L or 'self-reported diabetes medication use.' For all ethnicities, we analyzed sex, age, marital status, educational level, income status, employment, smoking status, residence, physical activity, body mass index, waist circumference, hypertension, and the levels of triglyceride, total cholesterol, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol.
  
  
  RESULTS
  The prevalence of prediabetes was 7.4%, while that of diabetes was 13 0%. From these diabetes cases, 39.6% were not diagnosed previously. No ethnic differences were observed in the prevalence of prediabetes. For diabetes, Hindustanis (23.3%) had twice the prevalence compared to other ethnic groups (4.7-14.2%). The associations of the risk factors with prediabetes or diabetes varied among the ethnic groups. The differences in the associations of ethnic groups with prediabetes or diabetes were partly explained by these risk factors.
  
  
  CONCLUSIONS
  The prevalence of diabetes in Suriname is high and most elevated in Hindustanis. The observed variations in risk factors among ethnic groups might explain the ethnic differences between these groups, but follow-up studies are needed to explore this in more depth.
authors.affiliation: Department of Public Health, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname.
authors.forename: Ingrid S K
authors.identifier: 0000-0001-7786-8869
authors.initials: IS
authors.lastname: Krishnadath
authors.affiliation: Department of Public Health, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname.
authors.forename: Lenny M
authors.initials: LM
authors.lastname: Nahar-van Venrooij
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Vincent W V
authors.identifier: 0000-0003-2939-0041
authors.initials: VW
authors.lastname: Jaddoe
authors.affiliation: Department of Physiology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname.
authors.forename: Jerry R
authors.identifier: 0000-0001-5504-0788
authors.initials: JR
authors.lastname: Toelsie
keywords: Epidemiology; Ethnic Disparities; Pre-Diabetes; Risk Factors