Vascular complications of black patients with type 2 diabetes mellitus in Southern Brazil

Ethnicity has been shown to be associated with micro- and macrovascular complications of diabetes in European and North American populations. We analyzed the contribution of ethnicity to the prevalence of micro- and macrovascular complications in Brazilian subjects with type 2 diabetes attending the national public health system. Data from 1810 subjects with type 2 diabetes (1512 whites and 298 blacks) were analyzed cross-sectionally. The rates of ischemic heart disease, peripheral vascular disease, stroke, distal sensory neuropathy, and diabetic retinopathy were assessed according to self-reported ethnicity using multiple logistic regression models. Compared to whites, black subjects [odds ratio = 1.72 (95%CI = 1.14-2.6)] were more likely to have ischemic heart disease when data were adjusted for age, sex, fasting plasma glucose, HDL cholesterol, hypertension, smoking habit, and serum creatinine. Blacks were also more likely to have end-stage renal disease [3.2 (1.7-6.0)] and proliferative diabetic retinopathy [1.9 (1.1-3.2)] compared to whites when data were adjusted for age, sex, fasting plasma glucose, HDL cholesterol, hypertension, and smoking habit. The rates of peripheral vascular disease, stroke and distal sensory neuropathy did not differ between groups. The higher rates of ischemic heart disease, end-stage renal disease and proliferative diabetic retinopathy in black rather than in white Brazilians were not explained by differences in conventional risk factors. Identifying which aspects of ethnicity confer a higher risk for these complications in black patients is crucial in order to understand why such differences exist and to develop more effective strategies to reduce the onset and progression of these complications.

Photograph - Robert Band as a child, cowboy outfit

Black and white photograph, 49 cm x 29 cm, of Robert Band as a child dressed in a cowboy outfit,

Photograph - Robert Band as a child, pond

Black and white photograph, 39 cm x 26 cm, of Robert Band as a child. The background is a pond and garden setting.

Photograph - Robert Band as a child

Black and white photograph, 31 cm x 26 cm, of Robert Band as a child [backdrop appears to be the Niagara River Parkway].

Photograph - Percy Band Eating Watermelon

Black and white, 12 ½ cm x 7 ½ cm photo of Percy Band eating watermelon. He is accompanied by a Margaret Woodruff. This photo also appears to have been cut from a scrapbook. There are 2 partial photos of 2 young couples on the back.

Photograph - Percy Band Eating Watermelon Close-up

Black and white photo of Percy Band eating watermelon. This picture is 5 cm x 4 cm.

Photograph - Margaret Julia Woodruff Band with Grandmother, Julia Amelia Canby Cleveland

Black and white photograph, enclosed in a folder, 13 ½ x 8 ½ cm, of Margaret Julia Woodruff Band as a child [with her grandmother Julia Amelia Canby Cleveland]. The photograph was taken by A. Joss, successor to E. Poole, St. Catharines, Ontario.

Photograph - Margaret Julia Woodruff Band as an adolescent

Black and white photograph, taken from a scrapbook, 10 cm. x 8 cm., of Margaret Julia Woodruff Band as an adolescent.

Photograph - Margaret Julia Woodruff Band in a Lace Dress

Black and white photograph, 17 cm x 13 ½, of Margaret Julia Woodruff Band in a seated position wearing a lace dress and a string of pearls. The photo was taken by Dudley Hoyt of New York.

Photograph - Margaret Julia Woodruff Band, Side Angle Lace Dress

Black and white photograph, 23 cm x 17 cm, of Margaret Julia Woodruff Band in a seated position, taken from a side angle. She is wearing a lace dress. The photo was taken by Dudley Hoyt of New York.

Photograph - Margaret Julia Woodruff Band, Lace Dress and Wide-Brimmed Hat

Black and white photograph, 23 cm x 17 cm, of Margaret Julia Woodruff Band in a seated position, wearing a lace dress and wide- brimmed hat. The photo was taken by Dudley Hoyt of New York.

Photograph - Margaret Julia Woodruff Band (Full Length Photograph)

Black and white photograph, 24 cm x 16 cm, of Margaret Julia Woodruff Band. This is a full length photograph in which she is wearing a lace dress. The photo was taken by Dudley Hoyt of New York.

Photograph - Margaret Julia Woodruff Band in a Wedding Dress

Black and white photograph, 17 cm x 13 cm, of Margaret Julia Woodruff Band in a seated position, wearing a wedding dress and veil. She is carrying flowers in her hand. A wedding band is evident in this photograph. The photo was taken by Dudley Hoyt of New York.

Photograph - Margaret Julia Woodruff Band in a Wedding Dress #2

Black and white photograph, enclosed in a folder, 17 cm x 13 cm, of Margaret Julia Woodruff Band in a seated position wearing a wedding gown and veil. The photo was taken by Dudley Hoyt of New York.

Photograph - Margaret Julia Woodruff Band in a Wedding Dress, in Silver Frame

Black and white photograph, 12 cm x 9 cm, of Margaret Julia Woodruff Band in a seated position, wearing a wedding dress and veil. The photo was taken by Dudley Hoyt of New York. The photo is encased within an ornate, silver frame which is engraved with the initials “M.J.W.”.