907 consecutive patients, (456 Asian and 451 Caucasian) were assessed, employing a similar methodology to the multi-centre WHO study. The Asians were older at diagnosis (46.5 years compared with 40.6 years, P < 0.01); they had a shorter duration of diabetes (6.3 years versus 11.4 years, P < 0.1), a higher rate of diabetes in the first degree relatives (29.5% compared with 16%, P < 0.1), less ketonuria at presentation (85.3% compared with 47.8%, P < 0.1), and fewer were treated with insulin (31.4% compared with 68.7%). Comparing the prevalence of complications between Asians and Caucasians, the ischaemic heart disease rate was similar; peripheral vascular disease was less (3.7% Asian, 9.3% Caucasian, P < 0.05); retinopathy was less (11.6% Asian, 32.3% Caucasian, P < 0.01) but renal disease was more (22.3% Asian, 12.6% Caucasian, P < 0.01). After adjusting for age, sex, duration of diabetes, age at diagnosis, hypertension, smoking and treatment with or without insulin, these differences remained significant. Multivariate logistic regression failed to reveal a significant contribution due to any of the above variables, or due to body mass index (BMI), haemoglobin A (HbA1), or physical activity in the prevalence of complications in Asians compared with Caucasians. Marked heterogeneity in the complications of diabetes in the two ethnic groups studied was found, but must be confirmed from population-based studies. © 1991.

Caucasian Peripheral vascular disease Diabetic retinopathy Migration Complications Asian Diabetes mellitus Diabetic renal disease Ischaemic heart disease

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