Abstract
Aims
This paper reviewed the literature on diabetes prevalence and risk factors associated
with diabetes among first-generation Chinese international migrants.
Methods
MEDLINE, Scopus, Web of Science, CINAHL and Maternity and Infant Care were searched
until March 2022, for articles written in English. The quality of the included articles
was assessed using the Newcastle-Ottawa Scale.
Results
In total, 17 articles were included (nine for gestational diabetes, six for type 2
diabetes, and none for type 1 diabetes). The average crude prevalence rate for type
2 diabetes and gestational diabetes was 12.1% and 9.3% respectively. Risk factors
contributing to the occurrence of type 2 diabetes included older age, sex, family
history of type 2 diabetes, higher BMI/waist circumference, longer time since migration,
alcohol consumption, smoker, hypertension, and high triglycerides. Risk factors contributing
to the occurrence of gestational diabetes included older maternal age, history of
gestational diabetes, higher weight/pre-pregnancy BMI, longer time since migration,
and Chinese ethnicity.
Conclusions
We identified a research gap in the diabetes health of Chinese migrants, particularly
for type 1 diabetes, highlighting the need for ethnic-specific diabetes research and
care, including for subsequent generations of migrants and those living in developing
countries.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Diabetes Research and Clinical PracticeAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025.Sci Rep. 2020; 10: 14790https://doi.org/10.1038/s41598-020-71908-9
- IDF Diabetes Atlas.9th ed. International Diabetes Federation, Brussels, Belgium2019
- The global economic burden of diabetes in adults aged 20–79 years: a cost-of-illness study.Lancet Diabetes Endocrinol. 2017; 5: 423-430https://doi.org/10.1016/S2213-8587(17)30097-9
- Epidemiology of type 2 diabetes – global burden of disease and forecasted trends.J Epidemiol Glob Health. 2020; 10: 107-111https://doi.org/10.2991/jegh.k.191028.001
- Economic costs of diabetes in the U.S. in 2017.Diabetes Care. 2018; 41: 917-928https://doi.org/10.2337/dci18-0007
- Understanding the economic costs of diabetes and prediabetes and what we may learn about reducing the health and economic burden of these conditions.Diabetes Care. 2019; 42: 1609-1611https://doi.org/10.2337/dci19-0017
- United Nations Department of economic and social affairs, population division [internet]. United Nations, New York2020 ([cited 2022 Aug 22]. International Migration 2020 Highlights. Available from:)
- Accessing social service support: barriers experienced by Chinese migrants living in Auckland, Aotearoa New Zealand.Aotearoa N Z Soc Work. 2020; 32: 131-144https://doi.org/10.3316/informit.825664240554149
- Diabetes management in a foreign land: a case study on Chinese Australians.Health Soc Care Community. 2018; 26: 225-232https://doi.org/10.1111/hsc.12501
- Self-management of gestational diabetes among Chinese migrants: a qualitative study.Women Birth. 2019; 32: 17-23https://doi.org/10.1016/j.wombi.2018.03.001
- Trends in prevalence of diabetes in Asian countries.World J Diabetes. 2012; 3: 110-117https://doi.org/10.4239/wjd.v3.i6.110
- Type 2 diabetes: demystifying the global epidemic.Diabetes. 2017; 66: 1432-1442https://doi.org/10.2337/db16-0766
- Disparities in the risk of gestational diabetes by race‐ethnicity and country of birth.Paediatr Perinat Epidemiol. 2010; 24: 441-448https://doi.org/10.1111/j.1365-3016.2010.01140.x
- Prevalence of gestational diabetes among Chinese and south Asians: a Canadian population-based analysis.J Diabetes Complications. 2016; 31: 529-536https://doi.org/10.1016/j.jdiacomp.2016.10.016
- Rates of obstetric intervention during birth and selected maternal and perinatal outcomes for low risk women born in Australia compared to those born overseas.BMC Pregnancy Childbirth. 2013; 13: 1-9https://doi.org/10.1186/1471-2393-13-100
- Prevalence, risk factors and complications associated with type 2 diabetes in migrant south Asians.Diabetes Metab Res Rev. 2012; 28: 6-24https://doi.org/10.1002/dmrr.1219
- The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.BMJ (Online). 2021; 372n71https://doi.org/10.1136/bmj.n71
- The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [internet].The Ottawa Hospital Research Institute, Ottawa2000 ([cited 2022 Aug 30]. Available from:)
- Cognitive outcome in congenital central hypothyroidism: a systematic review with meta-analysis of individual patient data.Eur J Endocrinol. 2020; 182: 351-361https://doi.org/10.1530/EJE-19-0874
- A systematic literature review of reported challenges in health care delivery to migrants and refugees in high-income countries - the 3C model.BMC Public Health. 2019; 19https://doi.org/10.1186/s12889-019-7049-x
- Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review.BMC Public Health. 2013; 13https://doi.org/10.1186/1471-2458-13-154
- Panethnic differences in blood pressure in Europe: a systematic review and meta-analysis.PLoS One. 2016; 11e0147601https://doi.org/10.1371/journal.pone.0147601
- Circumcision to prevent HIV and other sexually transmitted infections in men who have sex with men: a systematic review and meta-analysis of global data.Lancet Glob Health. 2019; 7: 436-447https://doi.org/10.1016/S2214-109X(18)30567-9
- Gestational diabetes among women of migrant origin in Finland–a population-based study.Eur J Public Health. 2021; 31: 784-789https://doi.org/10.1093/eurpub/ckab078
- Type 2 diabetes among 6 Asian ethnic groups in California: the Nexus of ethnicity, gender, and generational status.JHCPU. 2015; 26: 16-35https://doi.org/10.1353/hpu.2015.0061
- Ethnic enclaves and gestational diabetes among immigrant women in new York City.Soc Sci Med. 2014; 120: 180-189https://doi.org/10.1016/j.socscimed.2014.09.026
- The role of obesity in the risk of gestational diabetes among immigrant and U.S.-born women in new York City.Ann Epidemiol. 2018; 28: 242-248https://doi.org/10.1016/j.annepidem.2018.02.006
- Migration and diabetes incidence among Chinese adults in Canada, China, Hong Kong, and Taiwan: an international population-based comparative study from 2000 to 2017.Diabetes Res Clin Pract. 2021; 180109062https://doi.org/10.1016/j.diabres.2021.109062
- Impact of maternal nativity on the prevalence of diabetes during pregnancy among U.S. ethnic groups.Diabetes Care. 1999; 22: 729-735https://doi.org/10.2337/diacare.22.5.729
- Gestational diabetes risk in migrants. A Nationwide, register-based study of all births in Denmark 2004 to 2015.J Clin Endocrinol Metab. 2020; 105: 692-703https://doi.org/10.1210/clinem/dgaa024
- Exploring abnormal glucose metabolism in pregnancy among Australian Chinese migrants.BMJ Open Diabetes Res Care. 2020; 8e000903https://doi.org/10.1136/bmjdrc-2019-000903
- Comparison of type 2 diabetes prevalence in Chinese migrants vs Caucasians and new perspectives for screening of cerebrovascular disease in Chinese: a proof of concept study.Diabetes Res Clin Pract. 2017; 130: 196-203https://doi.org/10.1016/j.diabres.2017.05.023
- New findings on type 2 diabetes in first-generation Chinese migrants settled in Italy: Chinese in Prato (CHIP) cross-sectional survey.Diabetes Metab Res Rev. 2017; 33e2835https://doi.org/10.1002/dmrr.2835
- High prevalence of diabetes and impaired fasting glucose among Chinese immigrants in new York City.J Immigr Minor Health. 2011; 13: 181-183https://doi.org/10.1007/s10903-010-9356-2
- BMI and risk of gestational diabetes among women of south Asian and Chinese ethnicity: a population-based study.Diabetologia. 2021; 64: 805-813https://doi.org/10.1007/s00125-020-05356-5
- ‘Falling off the radar’ of public health: the case of uninsured Chinese patients in Vienna.Austria Health Policy. 2019; 123: 840-844https://doi.org/10.1016/j.healthpol.2019.04.002
- Prevalence of known diabetes in different ethnic groups in inner urban South Auckland.N Z Med J. 1999; 112: 316-319
- Gestational diabetes mellitus by maternal country of birth and length of residence in immigrant women in Norway.Diabet Med. 2020; 38e14493https://doi.org/10.1111/dme.14493
- Body mass index, demographic and socioeconomic risk, and protective factors of type 2 diabetes among six groups of foreign-born Asian Americans.J Soc Serv Res. 2014; 40: 429-439https://doi.org/10.1080/01488376.2014.919822
- Ethnic differences in prevalence, risk factors, and perinatal outcomes of gestational diabetes mellitus: a comparison between immigrant ethnic Chinese women and Australian-born Caucasian women in Australia.J Diabetes. 2019; 11: 809-817https://doi.org/10.1111/1753-0407.12909
- Diabetes Australia [Internet]. Diabetes Australia, Canberra2022 ([cited 2022 Oct 5]. Blood glucose monitoring. Available from:)
- Centres for disease control and prevention [internet]. U.S. Department of Health and Human Services, Atlanta2022 ([cited 2022 Aug 22]. National Diabetes Statistics Report. Available from:)
- Australian Government.([cited 2022a, Jul 22]. Diabetes: Australian facts. Available from:)
- The global epidemics of diabetes in the 21st century: current situation and perspectives.Eur J Prev Cardiol. 2019; 26: 7-14https://doi.org/10.1177/2047487319881021
- The UCL–Lancet Commission on migration and health: the health of a world on the move.Lancet. 2018; 392: 2606-2654https://doi.org/10.1016/S0140-6736(18)32114-7
- Economic development and the nutritional status of Chinese school-aged children and adolescents from 1995 to 2014: an analysis of five successive national surveys.Lancet Diabetes Endocrinol. 2019; 7: 288-299https://doi.org/10.1016/S2213-8587(19)30075-0
- Acculturation and nutritional health of immigrants in Canada: a scoping review.J Immigr Minor Health. 2014; 16: 24-34https://doi.org/10.1007/s10903-013-9823-7
- Acculturation and obesity among migrant populations in high income countries – a systematic review.BMC Public Health. 2013; 13https://doi.org/10.1186/1471-2458-13-458
- Diabetes in China: epidemiology and genetic risk factors and their clinical utility in personalized medication.Diabetes. 2018; 67: 3-11https://doi.org/10.2337/dbi17-0013
- Prevalence, awareness and associated risk factors of diabetes among adults in Xi’an, China.Sci Rep. 2017; 7: 10472https://doi.org/10.1038/s41598-017-10797-x
- Prevalence, awareness, treatment, and control of hypertension among Chinese first-generation migrants and Italians in Prato, Italy: the CHIP study.Int J Hypertens. 2017; 2017: 6402085https://doi.org/10.1155/2017/6402085
- Exploring the diet and lifestyle changes contributing to weight gain among Australian west African women following migration: a qualitative study.Contemp Nurse. 2018; 54: 150-159https://doi.org/10.1080/10376178.2018.1459760
- Acculturation and the prevalence of diabetes in US Latino adults, National Health and nutrition examination survey 2007-2010.PCD. 2014; 11https://doi.org/10.5888/pcd11.140142
- IDF diabetes atlas: estimation of global and regional gestational diabetes mellitus prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group’s Criteria.Diabetes Res Clin Pract. 2022; 183109050https://doi.org/10.1016/j.diabres.2021.109050
- Influence of acculturation on risk for gestational diabetes among Asian women.Prev Chronic Dis. 2019; 16190212https://doi.org/10.5888/pcd16.190212
- Racial/ethnic differences in gestational diabetes prevalence and contribution of common risk factors.Paediatr Perinat Epidemiol. 2015; 29: 436-443https://doi.org/10.1111/ppe.12209
Mayo Clinic [Internet]. 2022 [cited 2022 November 21]. Type 2 diabetes. Available from: https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193.
- The Royal Australian College of General Practitioners; Diabetes Australia.([cited 2020 Aug 22]. Management of type 2 diabetes: A handbook for general practice. Available from:)
Mayo Clinic [Internet]. 2022 [cited 2022, Apr 22]. Gestational diabetes. Available from: https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339.
- The prevalence of gestational diabetes mellitus recurrence—effect of ethnicity and parity: a metaanalysis.Am J Obstet Gynecol. 2015; 213: 310-317https://doi.org/10.1016/j.ajog.2015.03.011
- Type 2 diabetes mellitus and psychological stress – a modifiable risk factor.Nat Rev Endocrinol. 2017; 13: 547-560https://doi.org/10.1038/nrendo.2017.64
- Perceived discrimination, psychological distress and cardiovascular risk in migrants in Spain.Int J Environ Res Public Health. 2020; 17: 4601https://doi.org/10.3390/ijerph17124601
- Experiences of discrimination and self-reported health in Chinese migrants: a structural equation model.BMC Public Health. 2020; 20: 1477https://doi.org/10.1186/s12889-020-09588-3
- Distribution of health literacy strengths and weaknesses across socio-demographic groups: a cross-sectional survey using the health literacy questionnaire (HLQ).BMC Public Health. 2015; 15https://doi.org/10.1186/s12889-015-2056-z
- The participation rate of migrant women in gestational diabetes screening in Austria: a retrospective analysis of 3293 births.Arch Gynecol Obstet. 2019; 299: 345-351https://doi.org/10.1007/s00404-018-4964-5
- Health literacy as a social determinant of health in Asian American immigrants: findings from a population-based survey in California.J Gen Intern Med. 2015; 30: 1118-1124https://doi.org/10.1007/s11606-015-3217-6
- Assessing health literacy among Chinese speakers in the U.S. with limited English proficiency.HLRP. 2018; 2: 94-106https://doi.org/10.3928/24748307-20180405-01
- Optimum BMI cut points to screen Asian Americans for type 2 diabetes.Diabetes Care. 2015; 38: 814-820https://doi.org/10.2337/dc14-2071
- Impact of lowering BMI cut points as recommended in the revised American Diabetes Association’s Standards of Medical Care in Diabetes–2015 on diabetes screening in Asian Americans.Diabetes Care. 2015; 38: 2166-2168https://doi.org/10.2337/dc15-0299
- BMI cut points to identify at-risk Asian Americans for type 2 diabetes screening.Diabetes Care. 2015; 38: 150-158https://doi.org/10.2337/dc14-2391
Article info
Publication history
Published online: February 02, 2023
Accepted:
January 30,
2023
Received in revised form:
January 20,
2023
Received:
November 7,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
