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Ethnic differences in metabolic achievement between Māori, Pacific, and European New Zealanders with type 2 diabetes

Yu, D; Zhao, Z; Simmons, D; Baker, J; Cutfield, R; McKree Jansen, R; Orr-Walker, BJ; Sundborn, G; Cai, Y; Levi Osuagwu, U; Pickering, K


Z Zhao

D Simmons

J Baker

R Cutfield

R McKree Jansen

BJ Orr-Walker

G Sundborn

Y Cai

U Levi Osuagwu

K Pickering


Aims: To compare variations in metabolic target achievement by ethnicity (Europeans, Maori and Pasifika) among patients with type 2 diabetes (T2DM) in Auckland, New Zealand (NZ) between 1994 and 2013.

Methods: 32,237 patients were enrolled. Adjusted marginal difference (European as reference) of systolic blood pressure (SBP), body mass index (BMI), HbA1c and total cholesterol, alongside the proportion achieving metabolic targets were estimated using multivariable mixed effect models at baseline, 1-, 2-, 3-, 4-, and 5-years, adjusted for covariates.

Results: Compared with Europeans, Maori and Pasifika had continuously, significantly higher HbA1c (by 0.3% (+3.5 mmol/mol) and 0.6% (+6.8 mmol/mol) respectively and BMI (+1.5 and +0.3 kg/m(2) respectively) but lower SBP (-1.8 and -3.4 mmHg respectively) and TG (-0.03 and -0.34 mmol/L respectively), and insignificantly TC (+0.004 and +0.01 respectively), by 5-years of follow-up. While 49% Europeans were within target HbAlc, this was achieved by only 30% Maori and 27% Pasifika. Conversely, 41% Europeans, 46% Maori and 59% Pasifika achieved the SBP target (all P < 0.0001).

Conclusions: Managing hyperglycemia appears to be more challenging than treating hypertension and dyslipidemia among Maori and Pasifika. New anti-hyperglycemia treatments, addressing health literacy, socioeconomic and any cultural barriers to management and self-management are urgently needed to reduce these disparities.


Yu, D., Zhao, Z., Simmons, D., Baker, J., Cutfield, R., McKree Jansen, R., …Pickering, K. (2022). Ethnic differences in metabolic achievement between Māori, Pacific, and European New Zealanders with type 2 diabetes. Diabetes Research and Clinical Practice, 189, 109910 - 109910.

Journal Article Type Article
Acceptance Date May 3, 2022
Online Publication Date May 10, 2022
Publication Date 2022-07
Publicly Available Date May 30, 2023
Journal Diabetes Research and Clinical Practice
Print ISSN 0168-8227
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 189
Pages 109910 - 109910
Keywords Type 2 diabetes; Ethic disparity; Maori; Pasifika; New Zealand
Publisher URL