Disparity in Diabetes Risk Across Native Hawaiians and Different Asian Groups

Maskarinec, Gertraud; Jacobs, Simone; Morimoto, Yukiko; Chock, Marci; Grandinetti, Andrew; Kolonel, Laurence N.

doi:10.1177/1010539514548757

Cited by 17 publications

(16 citation statements)

References 34 publications

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“…Furthermore, early beta cell dysfunction has been noted in Asian patients, resulting in development of DM at a younger age. Even among Asian patients, in fact, differences in ethnic‐specific diabetes phenotypes also exist between East Asians and South Asians (Maskarinec et al., , ).…”

Section: Discussionmentioning

confidence: 99%

Immediate and long‐term effects of a very‐low‐calorie diet on diabetes remission and glycemic control in obese Thai patients with type 2 diabetes mellitus

Umphonsathien

Prutanopajai

Aiam-O-Ran

et al. 2019

Food Science & Nutrition

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Aim A very‐low‐calorie diet (VLCD) can reverse the underlying defects of type 2 diabetes mellitus (DM) in obese subjects. We determined the efficacy, safety, and durability of VLCD in Thai patients with DM and obesity. Methods Twenty Thai patients with DM and obesity were enrolled. After a 2‐week trial, VLCD (600 kcal/day) was continued for 8 weeks, followed by a 4‐week transition period. Data on diabetes remission (fasting plasma glucose level <126 mg/dl and HbA 1c <6.5% without the use of glucose‐lowering medications), glycemic control, metabolic parameters, and quality of life (QOL) were collected along with indices of insulin resistance (IR) and beta cell function. Glycemic control 12 months after discontinuation of VLCD was also examined. Results Among 19 patients (age 48 ± 2 years, BMI 27.7 kg/m 2 ) who completed the study, rapid improvement in glycemic control was observed in the first 2 weeks of VLCD. At both 8 and 12 weeks, diabetes remission was achieved in 79%. Significant weight loss was accompanied by a significant reduction in IR and an increase in beta cell function, starting at 4 weeks of VLCD. QOL also significantly increased. At 12 months after VLCD, however, DM remission was achieved in approximately 30%. Conclusion Very‐low‐calorie diet was effective and safe in inducing short‐term diabetes remission in Thai subjects by ameliorating beta cell function and IR. Optimal long‐term glycemic control was potentially durable as one‐third of subjects remained without diabetes medication 12 months after VLCD.

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Section: Discussionmentioning

confidence: 99%

Immediate and long‐term effects of a very‐low‐calorie diet on diabetes remission and glycemic control in obese Thai patients with type 2 diabetes mellitus

Umphonsathien

Prutanopajai

Aiam-O-Ran

et al. 2019

Food Science & Nutrition

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“…This difference in incidence can perhaps be explained by race‐specific variations in the susceptibility and severity of diabetes, which was a strong independent risk factor among Native Hawaiians in our analysis. Literature has shown that there is a disproportionate burden of diabetes among Native Hawaiians, as both the prevalence and risk of diabetes is much higher for Native Hawaiians compared to European Americans . There is also evidence suggesting that diabetes may be more critical and advanced in this population.…”

Section: Discussionmentioning

confidence: 99%

“…Literature has shown that there is a disproportionate burden of diabetes among Native Hawaiians, as both the prevalence and risk of diabetes is much higher for Native Hawaiians compared to European Americans. [26][27][28] There is also evidence suggesting that diabetes may be more critical and advanced in this population. Native Hawaiians are more frequently hospitalized for diabetes 29 and have a greater likelihood of experiencing diabetes-related complications and mortality.…”

Section: Discussionmentioning

confidence: 99%

Interethnic differences in pancreatic cancer incidence and risk factors: The Multiethnic Cohort

et al. 2019

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While disparity in pancreatic cancer incidence between blacks and whites has been observed, few studies have examined disparity in other ethnic minorities. We evaluated variations in pancreatic cancer incidence and assessed the extent to which known risk factors account for differences in pancreatic cancer risk among African Americans, Native Hawaiians, Japanese Americans, Latino Americans, and European Americans in the Multiethnic Cohort Study. Risk factor data were obtained from the baseline questionnaire. Cox regression was used to estimate the relative risks (RRs) and 95% confidence intervals (CIs) for pancreatic cancer associated with risk factors and ethnicity. During an average 16.9‐year follow‐up, 1,532 incident pancreatic cancer cases were identified among 184,559 at‐risk participants. Family history of pancreatic cancer (RR 1.97, 95% CI 1.50‐2.58), diabetes (RR 1.32, 95% CI 1.14‐1.54), body mass index ≥30 kg/m 2 (RR 1.25, 95% CI 1.08‐1.46), current smoking (<20 pack‐years RR 1.43, 95% CI 1.19‐1.73; ≥20 pack‐years RR 1.76, 95% CI 1.46‐2.12), and red meat intake (RR 1.17, 95% CI 1.00‐1.36) were associated with pancreatic cancer. After adjustment for these risk factors, Native Hawaiians (RR 1.60, 95% CI 1.30‐1.98), Japanese Americans (RR 1.33, 95% CI 1.15‐1.54), and African Americans (RR 1.20, 95% CI 1.01‐1.42), but not Latino Americans (RR 0.90, 95% CI 0.76‐1.07), had a higher risk of pancreatic cancer compared to European Americans. Interethnic differences in pancreatic cancer risk are not fully explained by differences in the distribution of known risk factors. The greater risks in Native Hawaiians and Japanese Americans are new findings and elucidating the causes of these high rates may improve our understanding and prevention of pancreatic cancer.

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“…African Americans ( 17 ), Latinos ( 17 ), and Japanese Americans ( 18 ) are at a high risk of developing diabetes and are more likely to have a higher prevalence of severe diabetes complications compared with non-Hispanic whites ( 15 ). The reason for severe diabetes among minorities may be due to an underuse of primary care physicians, poor medication adherence, and poor understanding of their disease ( 19–21 ).…”

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confidence: 99%

Diabetes-Related Complications and Pancreatic Cancer Incidence in the Multiethnic Cohort

Farias

Porcel

et al. 2020

JNCI Cancer Spectrum

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Background People with diabetes are at an increased risk of developing pancreatic cancer. However, it is unclear whether diabetes-related complications are associated with risk of pancreatic cancer. Methods A nested matched case-control analysis was conducted among the fee-for-service Medicare participants of the prospective Multiethnic Cohort (N∼123,000). Between 2001-2014, 433 incident cases of pancreatic ductal adenocarcinoma (PDAC) were matched to 1,728 controls by birth year, sex, race/ethnicity, and age at cohort entry. Participants were linked to data from the California and Hawaii cancer registries and Medicare claims. We used the diabetes complications severity index (DCSI) for the presence of 7 complications within two-years prior to the diagnosis date of the index case. Multivariable conditional logistic regression was used to examine the association of DCSI with pancreatic cancer incidence. Results Diabetes was present among 45.4% of cases and 34.1% of controls. Cases had higher DCSI score compared to controls (score ≥4: 32.8% in cases; 21.2% in controls). The most prevalent diabetes-related complications for cases were cardiovascular disease (61.2%), nephropathy (31.2%), and cerebrovascular disease (21.7%). Individuals with diabetes (OR: 1.48, 95% CI:1.14-1.91), nephropathy (OR:1.75, 95% CI:1.32-2.33), cardiovascular disease (OR:1.88, 95% CI:1.45-2.44), and metabolic complications (OR:6.61, 95% CI:2.49-17.50) were at increased risk of pancreatic cancer. For every 1-unit increase in DCSI score, participants had 18% greater risk of pancreatic cancer (OR: 1.18, 95% CI:1.11-1.25). Conclusions Participants with diabetes-related complications have an elevated risk of pancreatic cancer. Identifying diabetes-related complications may help identify high-risk groups who can be studied for development of early markers for this fatal cancer.

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Disparity in Diabetes Risk Across Native Hawaiians and Different Asian Groups

Cited by 17 publications

References 34 publications

Immediate and long‐term effects of a very‐low‐calorie diet on diabetes remission and glycemic control in obese Thai patients with type 2 diabetes mellitus

Immediate and long‐term effects of a very‐low‐calorie diet on diabetes remission and glycemic control in obese Thai patients with type 2 diabetes mellitus

Interethnic differences in pancreatic cancer incidence and risk factors: The Multiethnic Cohort

Diabetes-Related Complications and Pancreatic Cancer Incidence in the Multiethnic Cohort

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