NICE briefing published 21st January 2014
For health care professionals working with Asian and other black minority ethnic populations (BME), it is unsurprising that the incidence of T2DM, and cardiovascular disease is up to 6x higher (and occur at an earlier age) than in the white population. Due to a variety of genetic and environmental factors, this increased risk has not been recognised in guidelines (derived from white patient cohorts) which treat populations as a homogeneous group. Following from their 2013 guidance on assessing BMI in Asian and BME groups, NICE published BMI ‘trigger thresholds’ in these groups, specifically >23kg/m2 at increased risk of chronic conditions and 27.5kg/m2 at high risk (compared to 25 & 30 respectively for white adults). There is further recognition of the unique nature of this group especially relating to lower exercise and fruit intake and the increased prevalence of T2DM in children. The document also discusses issues arising from this including obesity, CVD prevention as and costs/ savings. However, whilst officially recognising physiological differences in BME populations, there is little specific guidance about how to improve poor outcomes in these difficult to manage high risk patients.