This retrospective, population-based, longitudinal cohort study found that poorer health outcomes for Māori and Pacific patients with type 2 diabetes, compared with European patients, have persisted for more than 20 years. Between January 1994 and July 2018, 45 072 patients with type 2 diabetes were enrolled in the Diabetes Care Support Service in Auckland and followed up for a median of 9.7 years. Although mortality decreased and hospital admissions increased across the three ethnic groups, hospital admissions were consistently higher in Māori and Pacific patients than European patients. Māori patients also had higher rates of all-cause mortality (adjusted incidence rate ratio [IRR] 1.96; 95% CI 1.80- 2.14), cardiovascular mortality (IRR 1.93; 95% CI 1.63-2.29) and cancer mortality (IRR 1.64; 95% CI 1.40-1.93) compared with European patients. There is an urgent need for new policies supporting prevention and more intensive management of type 2 diabetes in Māori and Pacific patients.
