Evidence map›Paper›PMID 26048210›Full record

Observational studyBMJ open2015

Impact of ethnicity on progress of glycaemic control in 131,935 newly diagnosed patients with type 2 diabetes: a nationwide observational study from the Swedish National Diabetes Register.

Araz Rawshani, Ann-Marie Svensson, Annika Rosengren, Björn Zethelius, Björn Eliasson, Soffia Gudbjörnsdottir

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Araz RawshaniDepartment of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden Sahlgrenska University Hospital, Gothenburg, Sweden.ORCID http://orcid.org/0000-0003-2066-3533
Ann-Marie SvenssonDepartment of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden Sahlgrenska University Hospital, Gothenburg, Sweden National Diabetes Register, Centre of Registers, Gothenburg, Sweden.
Annika RosengrenDepartment of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden Sahlgrenska University Hospital, Gothenburg, Sweden.
Björn ZetheliusDepartment of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden Medical Products Agency, Epidemiology, Uppsala, Sweden.
Björn EliassonDepartment of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden Sahlgrenska University Hospital, Gothenburg, Sweden National Diabetes Register, Centre of Registers, Gothenburg, Sweden.
Soffia GudbjörnsdottirDepartment of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden Sahlgrenska University Hospital, Gothenburg, Sweden National Diabetes Register, Centre of Registers, Gothenburg, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesStudies on ethnic disparities in glycaemic control have been contradictory, and compromised by excessively broad categories of ethnicity and inadequate adjustment for socioeconomic differences. We aimed to study the effect of ethnicity on glycaemic control in a large cohort of patients with type 2 diabetes.

settingWe used nationwide data (mainly from primary care) from the Swedish National Diabetes Register (2002-2011) to identify patients with newly diagnosed (within 12 months) type 2 diabetes.

participantsWe included 131,935 patients (with 713,495 appointments), representing 10 ethnic groups, who were followed up to 10 years. PRIMARY AND SECONDARY OUTCOME MEASURES: Progress of glycated haemoglobin (HbA1c) for up to 10 years was examined. Mixed models were used to correlate ethnicity with HbA1c (mmol/mol). The effect of glycaemic disparities was examined by assessing the risk of developing albuminuria. The impact of ethnicity was compared to that of income, education and physical activity.

resultsImmigrants, particularly those of non-Western origin, received glucose-lowering therapy earlier, had 30% more appointments but displayed poorer glycaemic control (2-5 mmol/mol higher HbA1c than native Swedes). Probability of therapy failure was 28-111% higher for non-Western groups than for native Swedes. High-income Western groups remained below the target-level of HbA1c for 4-5 years, whereas non-Western populations never reached the target level. These disparities translated into 51-92% higher risk of developing albuminuria. The impact of ethnicity was greater than the effect of income and education, and equal to the effect of physical activity.

conclusionsDespite earlier pharmacological treatment and more frequent appointments, immigrants of non-Western origin display poorer glycaemic control and this is mirrored in a higher risk of developing albuminuria.

Indexed as

AdultAlbuminuriaBlood GlucoseDiabetes Mellitus, Type 2Diet, DiabeticEducational StatusEmigrants and ImmigrantsGlycated HemoglobinHumansHypoglycemic AgentsIncomeRegistriesSwedenBlood GlucoseGlycated HemoglobinHypoglycemic AgentsDIABETES & ENDOCRINOLOGYEPIDEMIOLOGY

Identifiers

PMID26048210
PMCPMC4458585

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.