PLoS ONE
Volume 7, Issue 4, 2012

Impact of migration and acculturation on prevalence of type 2 diabetes and related eye complications in indians living in a newly urbanised society (Article) (Open Access)

Zheng Y. , Lamoureux E.L. , Ikram M.K. , Mitchell P. , Wang J.J. , Younan C. , Anuar A.R. , Tai E.-S. , Wong T.Y.
  • a Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
  • b Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore, Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
  • c Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore, Departments of Epidemiology and Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
  • d Centre for Vision Research, University of Sydney, Sydney, Australia
  • e Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia, Centre for Vision Research, University of Sydney, Sydney, Australia
  • f Centre for Vision Research, University of Sydney, Sydney, Australia
  • g Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore, Faculty of Medicine, University of Malaya Eye Research Centre, University of Malaya, Kuala Lumpur, Malaysia
  • h Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • i Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore, Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

Abstract

Background: Health of migrants is a major public health challenge faced by governments and policy makers. Asian Indians are among the fastest growing migration groups across Asia and the world, but the impact of migration and acculturation on diabetes and diabetes-related eye complications among Indians living in urban Asia remains unclear. Methodologies/Principal Findings: We evaluated the influence of migration and acculturation (i.e., migration status and length of residence) on the prevalence of type-2 diabetes mellitus (T2DM) and diabetes-related eye complications (diabetic retinopathy (DR) and cataract), among first-generation (defined as participant born in India with both parents born in India, n = 781) and second-generation (participants born in Singapore with both parents born in India, n = 1,112) Indian immigrants from a population-based study of Adult Indians in Singapore. Diabetes was defined as HbA1c≥6.5%, use of diabetic medication or a physician diagnosis of diabetes. Retinal and lens photographs were graded for the presence of DR and cataract. Compared to first generation immigrants, second generation immigrants had a higher age- and gender-standardized prevalence of T2DM (34.4% versus 29.0%, p<0.001), and, in those with T2DM, higher age- and gender-standardized prevalence of DR (31.7% versus 24.8%, p<0.001), nuclear cataract (13.6% versus 11.6%, p<0.001), and posterior sub-capsular cataract (6.4% versus 4.6%, p<0.001). Among first generation migrants, longer length of residence was associated with significantly younger age of diagnosis of diabetes and greater likelihood of having T2DM and diabetes-related eye complications. Conclusion: Second generation immigrant Indians and longer length of residence are associated with higher prevalence of diabetes and diabetes-related complications (i.e., DR and cataract) among migrant Indians living in Singapore. These data highlight potential worldwide impacts of migration patterns on the risk and burden of diabetes. © 2012 Zheng et al.

Author Keywords

[No Keywords available]

Index Keywords

eye photography antidiabetic agent urban area immigrant Asian Diabetic Retinopathy India Diabetes Complications hemoglobin blood level non insulin dependent diabetes mellitus Indian Diabetes Mellitus, Type 2 human sex difference middle aged statistics Asian continental ancestry group diabetes mellitus Eye Diseases controlled study subcapsular cataract randomized controlled trial Aged eye disease Urbanization hemoglobin A1c Cross-Sectional Studies cross-sectional study Humans male female risk factor cultural factor prevalence Article major clinical study adult migration physician Singapore age distribution Emigration and Immigration disease association onset age
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84859594011&doi=10.1371%2fjournal.pone.0034829&partnerID=40&md5=d467b0ec0db3991d3d46a9d26c39e8f3
DOI: 10.1371/journal.pone.0034829
ISSN: 19326203
Cited by: 26
Original Language: English