Metabolic Profiles of Maori, Pacific, and European New Zealanders With Type 2 Diabetes Over 25 Years.

Abstract

The population of New Zealand includes a high proportion of Maori (Indigenous Polynesian) and Pacific (Pasifika) people, who have been shown to experience worse type 2 diabetes mellitus (T2DM) outcomes than New Zealand Europeans (NZE), a phenomenon persisting for >20 years (1). It remains unclear which metabolic targets are not being achieved concurrent with these long-standing disparities in diabetes complications. In this study we compared five key clinical measurements routinely assessed in primary care (systolic blood pressure [SBP], BMI, HbA1c, total cholesterol [TC], and triglyceride [TG]) over time among patients with T2DM from these three main ethnic groups (Maori, NZE, and Pasifika). For this study we used the Diabetes Care Support Service (DCSS), a primary care diabetes audit program linked with national death registration, hospitalization, pharmaceutical claims, and socioeconomic databases, to identify a cohort of patients with T2DM (1). Ethics review was waived by the New Zealand Health and Disability Ethics Committees on 25 March 2019. Signed consent to participate was provided by an authorized signatory for each general practice. Adjusted marginal mean SBP, BMI, HbA1c, TC, and TG over baseline and 1, 2, 3, 4, and 5 years of follow-up among Maori, Pasifika, and NZE patients were estimated with mixed-effects models with adjustment for baseline characteristics (age, sex, smoking, socioeconomic status); baseline outcomes (e.g., baseline BMI, HbA1c, TC, and TG for comparing SBP over time); baseline antihypertensive, antidiabetes and lipid-lowering treatments and anticoagulant therapy; and the enrollment period as fixed effects. Multiple …