Diabetes Incidence Based on Linkages With Health Plans: The Multiethnic Cohort

Abstract

OBJECTIVEUsing the Hawaii component of the Multiethnic Cohort (MEC), we estimated diabetes incidence among Caucasians, Japanese Americans, and Native Hawaiians.RESEARCH DESIGN AND METHODSAfter excluding subjects who reported diabetes at baseline or had missing values, 93,860 cohort members were part of this analysis. New case subjects were identified through a follow-up questionnaire (1999–2000), a medication questionnaire (2003–2006), and linkage with two major health plans (2007). We computed age-standardized incidence rates and estimated hazard ratios (HRs) for ethnicity, BMI, education, and combined effects of these variables using Cox regression analysis.RESULTSAfter a total follow-up time of 1,119,224 person-years, 11,838 incident diabetic case subjects were identified with an annual incidence rate of 10.4 per 1,000 person-years. Native Hawaiians had the highest rate with 15.5, followed by Japanese Americans with 12.5, and Caucasians with 5.8 per 1,000 person-years; the adjusted HRs were 2.65 for Japanese Americans and 1.93 for Native Hawaiians. BMI was positively related to incidence in all ethnic groups. Compared with the lowest category, the respective HRs for BMIs of 22.0–24.9, 25.0–29.9, and ≥30.0 kg/m2 were 2.10, 4.12, and 9.48. However, the risk was highest for Japanese Americans and intermediate for Native Hawaiians in each BMI category. Educational achievement showed an inverse association with diabetes risk, but the protective effect was limited to Caucasians.CONCLUSIONSWithin this multiethnic population, diabetes incidence was twofold higher in Japanese Americans and Native Hawaiians than in Caucasians. The significant interaction of ethnicity with BMI and education suggests ethnic differences in diabetes etiology.

Statins, Risk of Diabetes, and Implications on Outcomes in the General Population

“…However, the information should be reviewed with caution because the incidence of diabetes in our study was 21 per 1,000 person-years, which was relatively more than in other investigations (16,17). Ethnic differences in diabetes occurrence and susceptibility to statins were reported (17)(18)(19). Therefore, we may have overestimated the potential risk for diabetes against the benefits of statins, especially in the cohort with a lower diabetes incidence.…”

“…In general, treatment of statins prevented 1 fatal event in 202 subjects and led to 1 case of diabetes in 301 patients per year. However, the information should be reviewed with caution because the incidence of diabetes in our study was 21 per 1,000 person-years, which was relatively more than in other investigations (16,17). Ethnic differences in diabetes occurrence and susceptibility to statins were reported (17)(18)(19).…”

Prevalencia de diabetes por diagnóstico médico previo en México

“…15,16 Vivir en áreas urbanas no estuvo asociado con prevalencia de diabetes. El aumento de la prevalencia en áreas rurales en esta encuesta puede deberse a una intensificación de las estrategias de tamizaje en esas regiones.…”

Coffee intake and risk of type 2 diabetes: the Multiethnic Cohort

“…The current analysis is limited to the Hawaii component, for which diabetes incidence data was available (1) . The Hawaii study population consisted of 103,898 participants, largely recruited using driver’s license files as the sampling frame.…”

“…These ethnic differences in risk can be partially explained by body mass index (BMI), physical activity, and dietary factors (1,2) , in particular meat and dietary fiber (3,4) . Reports from other cohorts have also suggested a protective effect of drinking coffee (5) , a widely consumed beverage that contains not only caffeine, but also minerals, phenolic compounds, and niacin (5,6) .…”