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A population-based study of diabetes incidence by ethnicity and age: support for the development of ethnic-specific prevention strategies

Creatore MI, Booth GL, Manuel DG, Moineddin R, Glazier RH. Can J Diabetes. 2020; 44(5):394-400. Epub 2020 Jan 7. DOI:

Objective — Although national guidelines advocate for earlier diabetes screening in high-risk ethnic groups, little evidence exists to guide clinicians on the age at which screening should commence. The purpose of this study was to determine age equivalency thresholds for diabetes risk across a broad range of ethnic populations.

Methods — This population-based, retrospective cohort study used linked administrative health and immigration records for 592,376 individuals in Ontario, Canada. Adjusted incidence rates by ethnicity, sex and age were used to derive ethnic-specific age thresholds for risk.

Results — Diabetes incidence rates in South Asians reached an equivalent risk as that experienced by a 40-year-old Western European man (3.7 per 1,000 person-years) by 25 years of age. For all other non-European ethnic groups, the equivalent risk was experienced between 30 and 35 years of age. These risk differentials persisted despite controlling for covariates.

Conclusions — We found a 15-year difference in age equivalency of risk across ethnic groups.