Inequalities in type 2 diabetes incidence in a multiethnic population: a cohort study investigating the impact of ethnicity, migration and mental health comorbidities – published online 22/04/2026

Diana Shamsutdinova, Daniel Stahl, Jayati Das‑Munshi

Ethnic disparities in the incidence of type 2 diabetes mellitus are well recognised, but whether migration history and mental health conditions explain—or compound—these inequalities has remained poorly understood, partly because migration status is rarely captured in routine health records. In this issue, Shamsutdinova et al (https://doi.org/10.1007/s00125-026-06740-3) report findings from a longitudinal cohort of 340,000 adults in South London followed from 2012 to 2019. South Asian, Black African and Black Caribbean individuals faced two to three times the type 2 diabetes risk of White British individuals, and these disparities persisted after accounting for socioeconomic and clinical factors. Being born outside of the UK independently raised type 2 diabetes risk by 30% across all ethnic groups. Depression and anxiety were associated with a 15% increase in risk, while severe mental illness nearly doubled it. Crucially, these three dimensions of disadvantage operated largely independently of one another, suggesting cumulative rather than interacting mechanisms. The authors conclude that these findings point to the need for targeted post-migration support alongside broader structural interventions to reduce persistent, inequitable diabetes risk.

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