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Recent immigrants at higher risk of developing diabetes: ICES study


Recent immigrants, particularly immigrants of South Asian and African origin, are at high risk of developing diabetes compared with long-term residents of Ontario. In the largest migrant study of its kind on diabetes ever undertaken in Canada, researchers at the Institute for Clinical Evaluative Sciences (ICES) and St. Michael’s found immigrants from South Asia had approximately double the risk of developing diabetes than the general Ontario population. Roughly 12 per cent of the entire South Asian community that immigrated in the previous 20 years has diabetes; this translates into more than 28,000 South Asian immigrants having been diagnosed with diabetes in Ontario as of 2005.

The study of more than one million immigrants to Ontario between 1985 and 2000 found:

  • Immigrant women had a 24 per cent and immigrant men had 10 per cent higher rate of diabetes than their Ontarian counterparts.
  •  There are nearly 100,000 people who immigrated between 1985 and 2000 who had been diagnosed with diabetes by 2005.
  • Risk among immigrants differs by country of birth. After controlling for factors such as age, education, income and time since arrival, diabetes risk in immigrants from South Asia was three to four times higher than in immigrants from Western European countries.
  • Men and women from Latin America and the Caribbean had more than double the risk of Western European immigrants.
  •  Increased risk for many immigrant groups started at an early age (35-49) – a full decade earlier than in the general Ontario population.
  • In Canada and elsewhere, men typically had higher rates of diabetes than women; however, among immigrants, women have as high a risk as men.
  • Lower socioeconomic status and increased time living in Canada, was associated with increased diabetes risk. Immigrants living in Canada for 15 years or more had a risk that was 1.5 times higher than immigrants who had lived in Canada only 5 to 9 years.

“Risk starts at an early age, suggesting that effective diabetes prevention programs are needed for youth and young adults in immigrant families. While women in Ontario experience lower risk than their male counterparts, risk for diabetes in recent immigrant women is similar to that for men and is much higher than for women in the general Ontario population,” says Marisa Creatore ICES doctoral student and epidemiologist at St. Michael’s Centre for Research on Inner City Health.

Author affiliations: ICES (M. I. Creatore, R. Moineddin, G. Booth, D. H. Manuel, R. H. Glazier); Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital (M. I. Creatore, G. Booth, R. H. Glazier); Institute for Medical Sciences, U of T (M. I. Creatore, R. H. Glazier); Dept of Family and Community Medicine, U of T (R. Moineddin, R. H. Glazier); Dept. of Public Health Sciences, U of T (D. H. Manuel, R. H. Glazier); Ottawa Health Research Institute (D. H. Manuel); Public Health Agency of Canada (M. DesMeules, S. McDermott).

The study “Age- and sex-related prevalence of diabetes mellitus among immigrants to Ontario, Canada,” is in the April 19, 2010 issue of CMAJ.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.



Read the Journal Article