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Mortality in first-...
Mortality in first- and second-generation immigrants to Sweden diagnosed with type 2 diabetes : a 10 year nationwide cohort study
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- Bennet, Louise (author)
- Lund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups,Lund Univ, Dept Clin Sci Malmö, Malmö, Sweden.;Lund Univ, Dept Family Med, Malmö, Sweden.
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- Udumyan, Ruzan (author)
- Örebro University,Örebro Univ, Sch Med Sci, Clin Epidemiol & Biostat, Örebro, Sweden.
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- Östgren, Carl Johan (author)
- Linköpings universitet,Linköping University,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Region Östergötland, Vårdcentralen Ekholmen,Linköping Univ, Dept Hlth Med & Caring Sci, Gen Practice, Linköping, Sweden.
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- Rolandsson, Olov (author)
- Umeå University,Umeå universitet,Allmänmedicin,Umeå Univ, Dept Publ Hlth & Clin Med, Family Med, Umeå, Sweden.
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- Jansson, Stefan P.O. 1959- (author)
- Uppsala universitet,Uppsala University,Örebro University,Orebro Univ, Sweden; Uppsala Univ, Sweden,Allmänmedicin och preventivmedicin,Örebro Univ, Univ Hlth Care Res Ctr, Inst Med Sci, Örebro, Sweden.
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- Wandell, Per (author)
- Karolinska Institutet,Karolinska Institute,Karolinska Inst, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
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(creator_code:org_t)
- 2020-09-26
- 2021
- English.
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In: Diabetologia. - : Springer. - 0012-186X .- 1432-0428. ; 64:1, s. 95-108
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Abstract
Subject headings
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- Aims/hypothesis: Non-Western immigrants to Europe are at high risk for type 2 diabetes. In this nationwide study including incident cases of type 2 diabetes, the aim was to compare all-cause mortality (ACM) and cause-specific mortality (CSM) rates in first- and second-generation immigrants with native Swedes.Methods: People living in Sweden diagnosed with new-onset pharmacologically treated type 2 diabetes between 2006 and 2012 were identified through the Swedish Prescribed Drug Register. They were followed until 31 December 2016 for ACM and until 31 December 2012 for CSM. Analyses were adjusted for age at diagnosis, sex, socioeconomic status, education, treatment and region. Associations were assessed using Cox regression analysis.Results: In total, 138,085 individuals were diagnosed with type 2 diabetes between 2006 and 2012 and fulfilled inclusion criteria. Of these, 102,163 (74.0%) were native Swedes, 28,819 (20.9%) were first-generation immigrants and 7103 (5.1%) were second-generation immigrants with either one or both parents born outside Sweden. First-generation immigrants had lower ACM rate (HR 0.80 [95% CI 0.76, 0.84]) compared with native Swedes. The mortality rates were particularly low in people born in non-Western regions (0.46 [0.42, 0.50]; the Middle East, 0.41 [0.36, 0.47]; Asia, 0.53 [0.43, 0.66]; Africa, 0.47 [0.38, 0.59]; and Latin America, 0.53 [0.42, 0.68]). ACM rates decreased with older age at migration and shorter stay in Sweden. Compared with native Swedes, first-generation immigrants with <= 24 years in Sweden (0.55 [0.51, 0.60]) displayed lower ACM rates than those spending >24 years in Sweden (0.92 [0.87, 0.97]). Second-generation immigrants did not have better survival rates than native Swedes but rather displayed higher ACM rates for people with both parents born abroad (1.28 [1.05, 1.56]).Conclusions/interpretation: In people with type 2 diabetes, the lower mortality rate in first-generation non-Western immigrants compared with native Swedes was reduced over time and was equalised in second-generation immigrants. These findings suggest that acculturation to Western culture may impact ACM and CSM in immigrants with type 2 diabetes but further investigation is needed.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Keyword
- All-cause mortality
- Cause-specific mortality
- First-generation
- Immigrants
- Incident
- Non-Western
- Second-generation
- Survival
- Type 2 diabetes
- All-cause mortality
- Cause-specific mortality
- First-generation
- Immigrants
- Incident
- Non-Western
- Second-generation
- Survival
- Type 2 diabetes
Publication and Content Type
- ref (subject category)
- art (subject category)
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