Elevated Incidence of Type 2 Diabetes in San Antonio, Texas, Compared With That of Mexico City, Mexico
- James P. Burke, PHD1,
- Ken Williams, MS2,
- Steven M. Haffner, MD2,
- Clicerio Gonzalez Villalpando, MD, FACP3 and
- Michael P. Stern, MD2
- 1Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
- 2Department of Medicine, Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- 3Centro de Estudios en Diabetes, the American British Cowdry Medical Center, Unidad de Investigacion Medica en Enfermedades Metabolicas, Hospital Bernardo Sepúlveda, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Abstract
OBJECTIVE—To compare the incidence of type 2 diabetes between low-income Mexican-Americans residing in San Antonio, Texas, and low-income residents in Mexico City, Mexico.
RESEARCH DESIGN AND METHODS—Using data from the San Antonio Heart Study and the Mexico City Diabetes Study, we compared the incidence of type 2 diabetes in 35- to 64-year-old low-income Mexican-American residents of San Antonio with similarly aged low-income residents of Mexico City. Because of the different follow-up times in the two studies, Poisson regression was used to compare the rates of diabetes. Potential risk factors for diabetes were also analyzed to determine whether they explained or contributed to a difference in incidence.
RESULTS—The age- and sex-adjusted incidence of type 2 diabetes was significantly higher in San Antonio (RR 2.01) compared with Mexico City. This difference was seen primarily in the oldest age group (55–64 years of age) and remained statistically significant after adjusting for a number of diabetes risk factors, including demographic, anthropometric, and metabolic variables. Follow-up rates were similar in both cities.
CONCLUSIONS—We conclude that there was a higher incidence of type 2 diabetes in San Antonio than in Mexico City, and that difference occurred primarily in individuals in the oldest age group. The potential mediating factors we examined did not account for this difference. Other factors, such as exercise and diet, which were not available for analysis in this study, in addition to a cohort effect, may have contributed to the difference in incidence of type 2 diabetes in the two cities. In addition, there was no evidence of a higher case fatality among diabetic individuals from Mexico City compared with San Antonio.
- IFG, impaired fasting glucose
- IGT, impaired glucose tolerance
- SAHS, San Antonio Heart Study
- STR, subscapular skin fold–to–triceps skin fold ratio
Footnotes
-
Address correspondence and reprint requests to James P. Burke, Department of Health Sciences Research, Harwick 6, Mayo Clinic, 200 First St. SW, Rochester, MN 55905. E-mail: jburke{at}mayo.edu.
Received for publication 9 January 2001 and accepted in revised form 7 June 2001.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
