Diabetes among Ethiopian Immigrants to Israel: Exploring the Effects of Migration and Ethnicity on Diabetes Risk

PLoS One. 2016 Jun 14;11(6):e0157354. doi: 10.1371/journal.pone.0157354. eCollection 2016.

Abstract

Objective: Diabetes prevalence among ethnic minorities and immigrants often differs from the majority indigenous population. We compared diabetes prevalence, incidence and risk among Ethiopian and non-Ethiopian Jews. Within these main groups, we controlled for the effect of migration on diabetes risk by comparing the subgroups of Ethiopian and former Soviet Union (FSU) immigrants, and compared both with Israeli-born non-Ethiopian Jews.

Methods: The study cohort included adult Ethiopian (n = 8,398) and age-matched non-Ethiopian Jews (n = 15,977) and subgroups: Ethiopian immigrants (n = 7,994), FSU immigrants (n = 1,541) and Israeli-born non-Ethiopian Jews (n = 10,828). Diabetes prevalence, annual incidence, and hazard ratios (HRs) adjusted for sex and metabolic syndrome (MetS)-components, were determined in three age groups (<50yrs, 50-59yrs, and ≥60yrs). Comparisons of body mass index (BMI) at diabetes incidence were made.

Results: Younger (<50yrs) Ethiopians had higher prevalence rates, 3.6% (95%CI: 3.1-4.1) and annual incidence, 0.9% (95%CI: 0.8-1.0) than non-Ethiopians, 2.7% (95%CI: 2.3-3.0) and 0.5% (95%CI: 0.4-0.6), respectively. These differences were particularly pronounced among Ethiopian women. Diabetes risk among Ethiopians was higher and adjustment for MetS-components was important only for BMI, which further increased hazard ratio (HR) estimates associated with Ethiopian ethnicity from 1.81 (95% CI:1.50-2.17) to 2.31 (95% CI:1.91-2.79). The same differences were seen when comparing Ethiopian to FSU immigrants. BMI before incident diabetes was lower among younger Ethiopian immigrants than younger FSU immigrants and Israeli-born.

Conclusions: Ethiopian ethnicity is associated with increased diabetes risk, which is age and BMI dependent. Young Ethiopians<50yrs, particularly women, had the greatest increase in risk. Lower BMI cut-offs should be defined to reflect diabetes risk among Ethiopians.

MeSH terms

  • Adult
  • Black People
  • Body Mass Index
  • Cohort Studies
  • Diabetes Mellitus / epidemiology*
  • Emigrants and Immigrants
  • Emigration and Immigration
  • Female
  • Humans
  • Incidence
  • Israel / epidemiology
  • Jews
  • Male
  • Middle Aged
  • Prevalence
  • Proportional Hazards Models
  • Risk Factors
  • Young Adult

Grants and funding

The authors have no support or funding to report.