Enhanced care to people of South Asian Ethnicity-the United Kingdom Asian Diabetes Study (UKADS)

The United Kingdom Asian Diabetes Study (UKADS) is a large community based cluster randomized controlled trial designed to evaluate a culturally sensitive intervention to reduce cardiovascular risk in south Asians with type 2 diabetes. The study was conducted over a 2 year period and involved 21 General Practices in Coventry and Birmingham. Two major components of the UKADS trial –the clinical intervention (chapters 2,3 and4 ) and the genetic characterization for type 2 diabetes susceptibility genes (chapters 5 to 8) are presented in this thesis. Over a 2 year period there were significant improvements in mean arterial and diastolic blood pressures in the intervention group that included additional practice nurse time, asian link workers and specialist diabetes nurse input. The intervention, however, had no effect on total cholesterol or glycaemic control. Prescription of statins and anti-hypertensives increased significantly during the study period with a greater proportion of subjects in both groups achieving General Practice targets for blood pressure and cholesterol. Genetics studies for association with type 2 diabetes showed a strong association with the common polymorphisms of the TCF7L2 gene. Studies for associations with other susceptibility genes with small effect sizes (PPARG, PPARG1A, CALPAIN10 ) were not adequately powered to detect possible associations