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Journal of Public Health Advance Access originally published online on February 5, 2009
Journal of Public Health 2009 31(2):239-249; doi:10.1093/pubmed/fdp003
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© The Author 2009, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Is there equity of service delivery and intermediate outcomes in South Asians with type 2 diabetes? Analysis of DARTS database and summary of UK publications



C. M. Fischbacher, Consultant in Public Health Medicine and Honorary Senior Lecturer1,2

R. Bhopal, Professor of Public Health2

M. Steiner, Clinical Research Fellow3

A. D. Morris, Professor of Diabetic Medicine4

J. Chalmers, Consultant in Public Health Medicine and Honorary Senior Lecturer1,2
1 Information Services Division, NHS National Services Scotland, Edinburgh EH12 9EB, UK
2 Department of Public Health Sciences, University of Edinburgh, Edinburgh EH8 9AG, UK
3 Environmental and Occupational Medicine, University of Aberdeen, Aberdeen AB25 2ZP, UK
4 Diabetes Research Group, Biomedical Research Institute, University of Dundee, Dundee DD1 9SY, UK

Address correspondence to Colin M. Fischbacher, E-mail: colin.fischbacher{at}isd.csa.scot.nhs.uk


  Abstract

Background There are doubts whether diabetes care is equitable across UK ethnic groups. We examined processes and outcomes in South Asians with diabetes and reviewed the UK literature.

Methods We used name search methods to identify South Asians in a regional diabetes database. We compared prevalence rates, processes and outcomes of care between November 2003 and December 2004. We used standard literature search techniques.

Results The prevalence of diabetes in South Asians was 3–4 times higher than non-South Asians. South Asians were 1.11 times (95% confidence interval 1.06, 1.16) more likely to have a structured review. South Asian women were 1.10 times more likely to have a record of body mass index (95% CI 1.04, 1.16). HbA1c levels were 1.03 times higher (95% CI 1.00, 1.06) among South Asians, retinopathy 1.36 times more common (95% CI 1.03, 1.78) and hypertension 0.71 times as common (95% CI 0.58, 0.87).

Conclusions We found evidence of equity in many aspects of diabetes care for South Asians in Tayside. The finding of higher HbA1c and more retinopathy among South Asians needs explanation and a service response. These findings from a region with a small non-White population largely support the recent findings from other parts of the UK.

Keywords: ethnic groups, outcome measures, quality of service, Scotland, South Asian, Tayside, type 2 diabetes mellitus


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