{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T16:43:42Z","timestamp":1765730622351,"version":"3.48.0"},"reference-count":26,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,4,3]]},"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this systematic review is to explore the association of South Asian (SA) ethnicity on comorbidities, microvascular and macrovascular complications and mortality compared with other ethnic groups in people with type 1 diabetes mellitus (T1DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A systematic literature search strategy was designed and carried out using Medline and Embase for full-text and abstract studies published in English from 1946 to February 2016. The initial search identified 4722 papers. We assessed 305 full-text articles in detail for potential inclusion. Ten papers met the inclusion criteria for review and an additional one paper was included from our secondary search strategy using the bibliography of included studies. In total, 11 studies were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria for selecting studies<\/jats:title>\n                    <jats:p>Studies were included if they were published in English, involved SA participants with T1DM and compared them with non-SA participants and assessed one of the outcomes of comorbidities, microvascular complications, macrovascular complications and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>SA with T1DM have higher mortality compared with white Europeans (WE), mainly contributed to by excess cardiovascular disease. SA have significantly higher glycated haemoglobin (HbA1c), lower high-density lipoprotein (HDL) and lower rates of neuropathy compared with WE. There were no differences in rates of retinopathy and nephropathy. Compared with Africans, SA had lower levels of microalbuminuria, HbA1c and systolic blood pressure and higher HDL levels. There were no significant differences in the remaining outcomes: cardiovascular disease, retinopathy, neuropathy and body mass index. Furthermore, SA have higher HbA1c levels than Malay and Chinese and higher waist\u00e2\u20ac\u201chip ratio and lower HDL levels compared with Chinese only.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our analysis highlights ethnic disparity in macrovascular outcomes that is so evident for type 2 diabetes mellitus may also be present for SA patients with T1DM. We highlight the need for a large, prospective, cohort study exploring the effect of ethnicity in a uniform healthcare setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-015005","type":"journal-article","created":{"date-parts":[[2017,7,14]],"date-time":"2017-07-14T20:10:17Z","timestamp":1500063017000},"page":"e015005","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Comorbidities, complications and mortality in people of South Asian ethnicity with type 1 diabetes compared with other ethnic groups: a systematic review"],"prefix":"10.1136","volume":"7","author":[{"given":"Komil N","family":"Sarwar","sequence":"first","affiliation":[{"name":"University of Birmingham, Edgbaston, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phoebe","family":"Cliff","sequence":"additional","affiliation":[{"name":"University of Birmingham, Edgbaston, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ponnusamy","family":"Saravanan","sequence":"additional","affiliation":[{"name":"University of Warwick, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamlesh","family":"Khunti","sequence":"additional","affiliation":[{"name":"University of Leicester, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishnarajah","family":"Nirantharakumar","sequence":"additional","affiliation":[{"name":"University of Birmingham, Edgbaston, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parth","family":"Narendran","sequence":"additional","affiliation":[{"name":"University of Birmingham, Edgbaston, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,7,13]]},"reference":[{"key":"2025121408415496000_7.7.e015005.1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2010.135"},{"key":"2025121408415496000_7.7.e015005.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2010.08.002"},{"key":"2025121408415496000_7.7.e015005.3","unstructured":"Department of Health. National Service Framework for Diabetes: standards, 2001."},{"key":"2025121408415496000_7.7.e015005.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.12.046"},{"key":"2025121408415496000_7.7.e015005.5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-1774"},{"key":"2025121408415496000_7.7.e015005.6","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1037\/fsh0000134","article-title":"Health disparities among youth with type 1 diabetes: A systematic review of the current literature","volume":"33","author":"Borschuk","year":"2015","journal-title":"Fam Syst Health"},{"key":"2025121408415496000_7.7.e015005.7","unstructured":"Office for National Statistics. Ethnicity and national identity in England and Wales. 2011, 2012."},{"key":"2025121408415496000_7.7.e015005.8","unstructured":"Wells G , Shea B , O'Connell D , et al . The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses Ottawa Hospital Research Institute ."},{"key":"2025121408415496000_7.7.e015005.9","unstructured":"Sarwar K , Gillani S , Singh B , et al . A comparison of diabetes type 1 in south asian and caucasian patients in the UK: the type 1 in Minority ethnic populations (TIME) study. European Association for the study of Diabetes. Abstract 2015."},{"key":"2025121408415496000_7.7.e015005.10","first-page":"1076","article-title":"Ethnic group differences in overweight and obese children with type 1 diabetes mellitus","volume":"89","author":"Shenoy","year":"2004","journal-title":"Arch Dis Child"},{"key":"2025121408415496000_7.7.e015005.11","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2011-130298"},{"key":"2025121408415496000_7.7.e015005.12","unstructured":"Brabarupan T , Misra S , Oliver N . A comparison of type 1 diabetes phenotype in a young multi-ethnic urban population. European Association for the study of Diabetes. Abstract 2013."},{"key":"2025121408415496000_7.7.e015005.13","first-page":"133","article-title":"Patterns of diabetes mellitus in young africans and Indians in Natal","volume":"36","author":"Omar","year":"1984","journal-title":"Trop Geogr Med"},{"key":"2025121408415496000_7.7.e015005.14","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2001.00494.x"},{"key":"2025121408415496000_7.7.e015005.15","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0683"},{"key":"2025121408415496000_7.7.e015005.16","first-page":"91","article-title":"Insulin-dependent diabetes mellitus with early onset in blacks and Indians","volume":"60","author":"Asmal","year":"1981","journal-title":"S Afr Med J"},{"key":"2025121408415496000_7.7.e015005.17","first-page":"75","article-title":"Complications of early-onset insulin-dependent diabetes mellitus in Blacks and Indians","volume":"65","author":"Omar","year":"1984","journal-title":"S Afr Med J"},{"key":"2025121408415496000_7.7.e015005.18","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0032182","article-title":"Ethnic variations in the prevalence of diabetic retinopathy in people with diabetes attending screening in the United Kingdom (DRIVE UK)","volume":"7","author":"Sivaprasad","year":"2012","journal-title":"PLoS One"},{"key":"2025121408415496000_7.7.e015005.19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2004.01253.x"},{"key":"2025121408415496000_7.7.e015005.20","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-2079"},{"key":"2025121408415496000_7.7.e015005.21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408214"},{"key":"2025121408415496000_7.7.e015005.22","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2010.490468"},{"key":"2025121408415496000_7.7.e015005.23","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60764-3"},{"key":"2025121408415496000_7.7.e015005.24","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0090813","article-title":"Body mass index and waist circumference cut-points in multi-ethnic populations from the UK and India: the ADDITION-Leicester, Jaipur heart watch and New Delhi cross-sectional studies","volume":"9","author":"Bodicoat","year":"2014","journal-title":"PLoS One"},{"key":"2025121408415496000_7.7.e015005.25","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-014-0476-5"},{"key":"2025121408415496000_7.7.e015005.26","doi-asserted-by":"crossref","unstructured":"UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2\u00e2 diabetes: ukpds 38. BMJ 1998;317. 703-713.","DOI":"10.1136\/bmj.317.7160.703"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-015005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T16:42:05Z","timestamp":1765730525000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-015005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7]]},"references-count":26,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2017,7,13]]},"published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1136\/bmjopen-2016-015005"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-015005","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2017,7]]}}}