Profile of diabetes mellitus among immigrants from Guyana: Epidemiology and implications for community action

Department of Family Medicine, Ellis Hospital, Schenectady, NY 12304, USA.
Ethnicity & disease (Impact Factor: 1). 11/2012; 22(4):473-8.
Source: PubMed


Prompted by anecdotal evidence of a higher rate of type 2 diabetes, we set out to investigate the prevalence of diabetes, its risk factors, and co-morbidities among immigrant Guyanese patients being treated in a family medicine health center in Schenectady, New York.
Patients were ascertained from a registration database of all patients aged > or = 30 years who were treated from 2004 to 2006. We then conducted a detailed retrospective chart review of all Guyanese, Caucasian, African American, and Hispanic patients with diabetes and randomly selected non-diabetic controls.
Of 222 Guyanese patients, 67 (30.2%) had a diagnosis of diabetes, compared with 47/219 (21.5%) of Hispanics, 132/777 (17.0%) of African Americans, and 442/2834 (15.6%) of Caucasians (P<.0001). Compared with the other racial and ethnic groups, the Guyanese diabetic patients were significantly leaner and more likely to be male.
We found a very high prevalence of type 2 diabetes among the Guyanese patient population studied and found unique characteristics when compared with other ethnic and racial groups. These findings have alerted local clinicians to intensify diabetes screening among Guyanese patients. Furthermore, in response to these findings, a broad coalition including public health, clinical, and community groups has been established with the goal of developing culturally appropriate strategies to prevent and control diabetes among Guyanese residents.

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    ABSTRACT: The Indo-Guyanese population is the largest immigrant minority population in Schenectady, New York. A clinic-based study in Schenectady and surveillance reports from Guyana found high diabetes prevalence and mortality among Guyanese of Indian descent. No community-based study has focused on diabetes among Indo-Guyanese immigrants in the United States. We sought information on the prevalence of diabetes and its complications in Indo-Guyanese adults in Schenectady and compared it with the prevalence among non-Hispanic white adults in Schenectady. We administered a cross-sectional health survey at community venues in Schenectady in 2011. We identified diagnosed diabetes and its complications through self-reports by using a reliability-tested questionnaire. The final data set included 313 Indo-Guyanese and 327 non-Hispanic white adults aged 18 years or older. We compared the prevalence of diagnosed diabetes and diabetes complications between Indo-Guyanese and non-Hispanic whites. Most Indo-Guyanese participants were born in Guyana, whereas most non-Hispanic whites were born in the United States. The crude prevalence of diagnosed diabetes among Indo-Guyanese participants and non-Hispanic whites was 30.3% and 16.1%, respectively. The age-standardized prevalence was 28.7% among Indo-Guyanese participants, significantly higher than that among non-Hispanic whites (14.5%, P < .001). Indo-Guyanese participants who had diabetes had a lower body mass index and were more likely to report poor or fair general health and eye or vision complications than non-Hispanic whites who had diabetes. Our study confirms the higher prevalence of diabetes in Indo-Guyanese adults in Schenectady. The higher prevalence of complications suggests poor control of diabetes. Excess burden of diabetes in this population calls for further research and public health action.
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