Relationship between ethnicity and glycemic control, lipid profiles, and blood pressure during the first 9 years of type 2 diabetes - UK prospective diabetes study (UKPDS 55)

OBJECTIVE - To assess the relationship among self-reported ethnicity, metab olic control, and blood pressure during treatment of type 2 diabetes. RESEARCH DESIGN AND METHODS - We studied 2,999 newly diagnosed type 2 diabe tic patients recruited to the U.K. Prospective Diabetes Study who were rand omized to conventional or intensive glucose control policies if their fasti ng plasma glucose levels remained >6 mmol/l after a dietary run-in. A total of 2,484 patients (83%) were white Caucasian (WC), 265 patients (9%) were Afro-Caribbean (AC), and 250 patients (8%) were Asian of Indian origin (W). Variables were assessed at 3, 6, and 9 years. RESULTS - During the 9-year study period, body weight increased more in WC patients (mean 5.0 kg) than in AC (3.0 kg) and W.(2.5 kg) patients (P < 0.0 01). After adjusting for age, sex, baseline value, treatment allocation, an d change in weight, there were no consistent ethnic differences in mean cha nge in lasting plasma glucose or HM1c. After adjustment for antihypertensiv e therapy, increase in systolic blood pressure at 9 years was greatest in A C patients (7 mmHg; P < 0.01 vs. WC patients). Mean diastolic blood pressur e, total cholesterol, and LDL cholesterol decreased progressively during th e 9 years in each group. In AC patients, the mean increase in HDL cholester ol(0.16 mmol/l) at 3 years, maintained to 9 years, and the mean decrease in plasma triglyceride level (0.4 mmol/l) at 9 years were greater than in WC and IA patients (P < 0.001). CONCLUSIONS - This study shows important ethnic differences in body weight, lipid profiles, and blood pressure, but not glycemic control, during 9 yea rs after diagnosis of type 2 diabetes. AC patients maintained the most favo rable lipid profiles, but hypertension developed in more AC patients than W C or IA patients. Ethnicity-specific glycemic control of type 2 diabetes se ems unnecessary, but other risk factors need to be addressed independently.