Type 2 Diabetes in Ethnic Minority Groups in Europe

Abstract

Type 2 diabetes (T2D) is well established as an important risk factor for cardiovascular disease. The global burden of T2D is increasing rapidly, in particular, in low- and middle-income countries. Ethnic minority groups in Europe are up to four times more likely to be affected by T2D compared to Europeans and are also disproportionally affected compared to their compatriots in their countries of origin. The reasons for this disproportionate burden are unclear but are believed to be an interplay between genetic and environmental factors. The underlying pathophysiology of T2D seems to differ between ethnic groups, with most ethnic minority groups having higher insulin resistance compared to Europeans even in a normoglycaemic state. Furthermore, while obesity is an important determinant of T2D across ethnic groups, higher levels of obesity in ethnic minority groups only explain part of their higher T2D burden. Health-related behaviours such as diet and physical activity can contribute to T2D among ethnic minority groups either mediated via obesity or directly. Few genetic factors have been identified that may predispose ethnic minority groups to T2D, but more diversity in genetics research is needed to get a better picture of genetic predispositions for T2D among ethnic minority groups. In the meantime, adaptation of population-based lifestyle interventions to ethnic minority groups, and evaluation of these interventions, is crucial to curb the rise of T2D among ethnic minority groups. Early detection is essential for prevention of micro- and macrovascular complications contributing to cardiovascular disease.