Comparison between England and The Netherlands of fasting glucose and diabetes in South-Asian and African origin populations: does it matter where you have migrated to?

Background
Ethnic inequalities in diabetes are well documented in theindustrialized countries. Evidence also suggests that theprevalence of type 2 diabetes mellitus (DM) is higher inThe Netherlands than in the UK. It is unclear whether thesedifferences reflect on South-Asian and African origin popula-tions living these countries. We therefore (i) to examine ethnicdifferences in mean fasting glucose (FG) and the prevalence oftype 2 DM in two countries (The Netherlands and England);(ii) to determine whether the lower DM prevalence in Englandversus The Netherlands is also observed in South-Asian andAfrican origin populations; and (iii) to assess the contributionof health behaviour, body sizes and socio-economic position toany observed differences.
Methods
Secondary analyses of population-based standardized indivi-dual level studies of 3386 participants from England andThe Netherlands. Analyses of FG and prevalence ratios (PRs)of DM were performed using regression models.
Results
South-Asian Indian and African origin populations in Englandand The Netherlands had higher FG and DM rates thantheir White counterparts. Among Whites, White-English hada lower FG and DM prevalence than White-Dutch afteradjustment for other covariates:= –0.34 mmol/l [95%confidence interval (CI)0.51,–0.18] and PR = 0.45 (95% CI0.24–0.84) for men; and= –0.18 mmol/l (95% CI0.36,0.02) for women. Among Indians, English-Indians hada lower FG and DM prevalence than Dutch-Indians;differences with women remained after adjustments forother factors: FG (= –0.51 mmol/l, 95% CI–0.97,0.05)and DM (PR = 0.35, 95% CI 0.22–0.55). Among Africans,English-(African)-Caribbean women had a lower FG andDM rate than Dutch-Africans; the difference in DMprevalence persisted after covariate adjustments: PR = 0.43(95% CI 0.20–0.89).
Conclusions
Similar to the Whites, the FG and DM rates were lower inEnglish ethnic minority groups than their Dutch equivalents.These findings indicate that the actual increase of DM in ethnicminority populations is dependent on circumstances in theresiding countries. More work is needed to unravel thecontextual factors involved