Differential manifestation of type 2 diabetes in Black Africans and White Europeans with recently diagnosed type 2 diabetes: A systematic review

Abstract

ABSTRACTAimsThe clinical manifestation of type 2 diabetes (T2D) varies across populations. We compared the phenotypic characteristics of Black Africans and White Europeans with recently diagnosed T2D to understand the ethnic differences in the manifestation of T2D.MethodsWe searched Medline, EMBASE, CINAHL, Google Scholar, African Index Medicus, and Global Health for studies reporting information on phenotypic characteristics in Black Africans and White Europeans with recently diagnosed T2D.ResultsA total of 26 studies were included in this systematic review. Of these, 12 studies and 14 studies were conducted on 2,586 Black Africans in eight countries and 279,621 White Europeans in nine countries, respectively. Compared with White Europeans, Black Africans had a lower pooled mean age (49.4±4.4 years vs. 61.3±2.7 years), body mass index (26.1±2.6 kg/m2vs. 31.4±1.1 kg/m2), and a higher pooled median glycated haemoglobin (9.0 [8.0-10.3]% vs. 7.1 [6.7-7.7]%). Ugandan and Tanzanian participants had lower markers of beta-cell function and insulin resistance when compared with four White European populations.ConclusionThese findings provide evidence of the ethnic differences in the manifestation of T2D, underscoring the importance of understanding the underlying genetic and environmental factors influencing these phenotypic differences and formulating ethnic-specific approaches for managing and preventing T2D.HIGHLIGHTSEmerging evidence suggests differences in the presentation of type 2 diabetes in Black Africans and White Europeans.In this systematic review, we reported that compared with White Europeans, Black Africans presented with a lower mean age and body mass index, less co-existing hypertension, and more hyperglycaemia at the time of diagnosis of type 2 diabetes.Compared with some White European populations, Ugandan and Tanzanian participants presented with features of pancreatic beta-cell dysfunction and less insulin resistance.