Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

High prevalence of type 2 diabetes in Iraqi and Swedish residents in a deprived Swedish neighbourhood - a population based study

Authors: Louise Bennet, Sven-Erik Johansson, Carl-David Agardh, Leif Groop, Jan Sundquist, Lennart Råstam, Kristina Sundquist

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

Immigrants from the Middle-East are at high risk of developing type 2 diabetes (T2D). The aim of the present survey was to measure, in a single deprived neighbourhood, the prevalence rates of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and T2D in residents originating from Iraq and to compare them to those in residents born in Sweden. An additional aim was to identify metabolic, lifestyle and socioeconomic risk factors associated with IFG/IGT and T2D in these residents.

Methods

The study was conducted February 1'st to March 31'st 2010. Men and women aged 45 to 65 years of Swedish or Iraqi origin, living in the neighbourhood of Rosengård, Malmö, Sweden, were randomly selected from the census register. Each participant signed a written informed consent form, underwent a physical examination and an oral glucose tolerance test (OGTT), provided blood samples and filled in a questionnaire. A total of 175 subjects participated (Swedish origin n = 79, Iraqi origin n = 96), reflecting an overall response rate of almost 60%.

Results

In total, 21.9% and 19.0% of the Iraqi and Swedish participants, respectively, suffered from T2D, while 24.0% of the Iraqi participants and 25.3% of the Swedish participants had IFG/IGT. There were no significant differences in prevalence rates relating to country of origin.
Obesity (BMI ≥30 kg/m2) and sedentary leisure time physical activity were highly prevalent in both groups, while a family history of diabetes was more prevalent in participants from Iraq (49.2%) than in those from Sweden (22.8%) (p = 0.001).
Being obese or having a sedentary leisure time were, independently associated with T2D (OR 5.43 (95% CI 2.10-14.02) and 2.89 (95% CI 1.03-8.10) respectively), while economic difficulties were independently associated with IFG/IGT (OR 2.55 (95% CI 1.06-6.15)) after adjustment for the confounding effects of other common risk factors for T2D.

Conclusions

This study reveals a high prevalence of T2D, independently of country of origin (Iraq or Sweden), in a socially vulnerable area and additionally presents a risk factor profile that is markedly different from that of Sweden in general.
Appendix
Available only for authorised users
Literature
1.
Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M: Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998, 339 (4): 229-234. 10.1056/NEJM199807233390404.CrossRefPubMed
2.
Unwin N, Shaw J, Zimmet P, Alberti KG: Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention. Diabet Med. 2002, 19 (9): 708-723.CrossRefPubMed
3.
Berger B, Stenstrom G, Sundkvist G: Incidence, prevalence, and mortality of diabetes in a large population. A report from the Skaraborg Diabetes Registry. Diabetes Care. 1999, 22 (5): 773-778. 10.2337/diacare.22.5.773.CrossRefPubMed
4.
Jansson SP, Andersson DK, Svardsudd K: Prevalence and incidence rate of diabetes mellitus in a Swedish community during 30 years of follow-up. Diabetologia. 2007, 50 (4): 703-710. 10.1007/s00125-007-0593-4.CrossRefPubMed
5.
Lyssenko V, Almgren P, Anevski D, Perfekt R, Lahti K, Nissen M, Isomaa B, Forsen B, Homstrom N, Saloranta C, et al: Predictors of and longitudinal changes in insulin sensitivity and secretion preceding onset of type 2 diabetes. Diabetes. 2005, 54 (1): 166-174. 10.2337/diabetes.54.1.166.CrossRefPubMed
6.
7.
Mansour AA, Wanoose HL, Hani I, Abed-Alzahrea A: Diabetes screening in Basrah, Iraq: a population-based cross-sectional study. Diabetes Res Clin Pract. 2008, 79 (1): 147-150. 10.1016/j.diabres.2007.07.016.CrossRefPubMed
8.
Glans F, Elgzyri T, Shaat N, Lindholm E, Apelqvist J, Groop L: Immigrants from the Middle-East have a different form of Type 2 diabetes compared with Swedish patients. Diabet Med. 2008, 25 (3): 303-307. 10.1111/j.1464-5491.2007.02366.x.CrossRefPubMed
9.
Sundquist J, Winkleby MA: Cardiovascular risk factors in Mexican American adults: a transcultural analysis of NHANES III, 1988-1994. Am J Public Health. 1999, 89 (5): 723-730. 10.2105/AJPH.89.5.723.CrossRefPubMedPubMedCentral
10.
Wandell PE, Johansson SE, Gafvels C, Hellenius ML, de Faire U, Sundquist J: Estimation of diabetes prevalence among immigrants from the Middle East in Sweden by using three different data sources. Diabetes Metab. 2008, 34 (4 Pt 1): 328-333.CrossRefPubMed
11.
Dixon LB, Sundquist J, Winkleby M: Differences in energy, nutrient, and food intakes in a US sample of Mexican-American women and men: findings from the Third National Health and Nutrition Examination Survey, 1988-1994. Am J Epidemiol. 2000, 152 (6): 548-557. 10.1093/aje/152.6.548.CrossRefPubMed
12.
Neuhouser ML, Thompson B, Coronado GD, Solomon CC: Higher fat intake and lower fruit and vegetables intakes are associated with greater acculturation among Mexicans living in Washington State. J Am Diet Assoc. 2004, 104 (1): 51-57. 10.1016/j.jada.2003.10.015.CrossRefPubMed
13.
Gadd M, Sundquist J, Johansson SE, Wandell P: Do immigrants have an increased prevalence of unhealthy behaviours and risk factors for coronary heart disease?. Eur J Cardiovasc Prev Rehabil. 2005, 12 (6): 535-541. 10.1097/00149831-200512000-00004.CrossRefPubMed
14.
Nilsson PM, Johansson SE, Sundquist J: Low educational status is a risk factor for mortality among diabetic people. Diabet Med. 1998, 15 (3): 213-219. 10.1002/(SICI)1096-9136(199803)15:3<213::AID-DIA569>3.0.CO;2-#.CrossRefPubMed
15.
Robinson N, Lloyd CE, Stevens LK: Social deprivation and mortality in adults with diabetes mellitus. Diabet Med. 1998, 15 (3): 205-212. 10.1002/(SICI)1096-9136(199803)15:3<205::AID-DIA519>3.0.CO;2-#.CrossRefPubMed
16.
17.
Sundquist K, Winkleby M, Ahlen H, Johansson SE: Neighborhood socioeconomic environment and incidence of coronary heart disease: a follow-up study of 25,319 women and men in Sweden. Am J Epidemiol. 2004, 159 (7): 655-662. 10.1093/aje/kwh096.CrossRefPubMed
18.
Evans JM, Newton RW, Ruta DA, MacDonald TM, Morris AD: Socio-economic status, obesity and prevalence of Type 1 and Type 2 diabetes mellitus. Diabet Med. 2000, 17 (6): 478-480. 10.1046/j.1464-5491.2000.00309.x.CrossRefPubMed
19.
Malmstrom M, Sundquist J, Bajekal M, Johansson SE: Indices of need and social deprivation for primary health care. Scand J Soc Med. 1998, 26 (2): 124-130.PubMed
20.
Sundquist K, Malmstrom M, Johansson SE, Sundquist J: Care Need Index, a useful tool for the distribution of primary health care resources. J Epidemiol Community Health. 2003, 57 (5): 347-352. 10.1136/jech.57.5.347.CrossRefPubMedPubMedCentral
21.
1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. Guidelines Subcommittee. J Hypertens. 1999, 17 (2): 151-183.
22.
Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report: National Institutes of Health. Obes Res. 1998, 6 (Suppl 2): 51S-209S.
23.
Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, et al: Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004, 364 (9438): 937-952. 10.1016/S0140-6736(04)17018-9.CrossRefPubMed
24.
Thorell J, Larson SM: Radioimmunoassay and related techniques. The CV Mosby Company, ST Louis. 1978, 205-211.
25.
Allain CC, Poon LS, Chan CS, Richmond W, Fu PC: Enzymatic determination of total serum cholesterol. Clin Chem. 1974, 20 (4): 470-475.PubMed
26.
Friedewald WT, Levy RI, Fredrickson DS: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972, 18 (6): 499-502.PubMed
27.
von Schenck H, Falkensson M, Lundberg B: Evaluation of "HemoCue," a new device for determining hemoglobin. Clin Chem. 1986, 32 (3): 526-529.PubMed
28.
World Health Organization: Definition, diagnosis and classification of diabetes mellitus and its complications: Report of a WHO consultation. Part 1. Diagnosis and classification of diabetes mellitus. 1999, Geneva, World Health Organization
29.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985, 28 (7): 412-419. 10.1007/BF00280883.CrossRefPubMed
30.
Matsuda M, DeFronzo RA: Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care. 1999, 22 (9): 1462-1470. 10.2337/diacare.22.9.1462.CrossRefPubMed
31.
Sepp H, Ekelund U, Becker W: Enkätfrågor om kost och fysisk aktivitet bland vuxna. Livsmedelsverket. 2004, rapport 21
32.
Bakkevig O, Steine S, von Hafenbradl K, Laerum E: Smoking cessation. A comparative, randomised study between management in general practice and the behavioural programme SmokEnders. Scand J Prim Health Care. 2000, 18 (4): 247-251. 10.1080/028134300448832.CrossRefPubMed
33.
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M: Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993, 88 (6): 791-804. 10.1111/j.1360-0443.1993.tb02093.x.CrossRefPubMed
34.
35.
van Dieren S, Beulens JW, van der Schouw YT, Grobbee DE, Neal B: The global burden of diabetes and its complications: an emerging pandemic. Eur J Cardiovasc Prev Rehabil. 17 (Suppl 1): S3-8.
36.
Faskunger J, Eriksson U, Johansson SE, Sundquist K, Sundquist J: Risk of obesity in immigrants compared with Swedes in two deprived neighbourhoods. BMC Public Health. 2009, 9: 304-10.1186/1471-2458-9-304.CrossRefPubMedPubMedCentral
37.
Lyssenko V, Jonsson A, Almgren P, Pulizzi N, Isomaa B, Tuomi T, Berglund G, Altshuler D, Nilsson P, Groop L: Clinical risk factors, DNA variants, and the development of type 2 diabetes. N Engl J Med. 2008, 359 (21): 2220-2232. 10.1056/NEJMoa0801869.CrossRefPubMed
38.
Manson JE, Rimm EB, Stampfer MJ, Colditz GA, Willett WC, Krolewski AS, Rosner B, Hennekens CH, Speizer FE: Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet. 1991, 338 (8770): 774-778. 10.1016/0140-6736(91)90664-B.CrossRefPubMed
39.
Marmot M, Friel S, Bell R, Houweling TA, Taylor S: Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008, 372 (9650): 1661-1669. 10.1016/S0140-6736(08)61690-6.CrossRefPubMed
40.
41.
Hoerger TJ, Hicks KA, Sorensen SW, Herman WH, Ratner RE, Ackermann RT, Zhang P, Engelgau MM: Cost-effectiveness of screening for pre-diabetes among overweight and obese U.S. adults. Diabetes Care. 2007, 30 (11): 2874-2879. 10.2337/dc07-0885.CrossRefPubMed
42.
Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002, 346 (6): 393-403.CrossRefPubMed
43.
Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, et al: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001, 344 (18): 1343-1350. 10.1056/NEJM200105033441801.CrossRefPubMed
Metadata
Title
High prevalence of type 2 diabetes in Iraqi and Swedish residents in a deprived Swedish neighbourhood - a population based study
Authors
Louise Bennet
Sven-Erik Johansson
Carl-David Agardh
Leif Groop
Jan Sundquist
Lennart Råstam
Kristina Sundquist
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-303

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue

Research article

Social and cultural dimensions of hygiene in Cambodian health care facilities

Research article

Validation of metabolic syndrome using medical records in the SUN cohort

Research article

Parenthood and factors that influence outdoor recreational physical activity from a gender perspective

Study protocol

Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and status in Cambodia

Research article

Low usage of government healthcare facilities for acute respiratory infections in guatemala: implications for influenza surveillance

Research article

Public perceptions and attitudes toward thalassaemia: Influencing factors in a multi-racial population