Type 2 diabetes among Asian Americans: Prevalence and prevention

Abstract

Type 2 diabetes mellitus (T2DM) is a growing problem among Asian Americans. Based on the Centers for Disease Control, the age-adjusted prevalence of T2DM for Asian Americans is 9%, placing them at "moderate risk". However differential patterns of disease burden emerge when examining disaggregated data across Asian American ethnic groups; with Filipino, Pacific Islander, Japanese, and South Asian groups consistently described as having the highest prevalence of T2DM. Disentangling and strengthening prevalence data is vital for on-going prevention efforts. The strongest evidence currently available to guide the prevention of T2DM in the United States comes from a large multicenter randomized clinical control trial called the Diabetes Prevention Program, which targets individual lifestyle behavior changes. It has been translated and adopted for some Asian American groups, and shows promise. However stronger study designs and attention to several key methodological considerations will improve the science. Increased attention has also been directed toward population level downstream prevention efforts. Building an infrastructure that includes both individual and population approaches is needed to prevent T2DM among Asian American populations, and is essential for reducing health disparities.

Ethnic Group Differences in Health Outcomes Among Asian American Men in California

“…Self-reported health status was selected for further analysis given the dearth of data examining this variable among different subethnic groups of Asian American men. Asian American men have been identified to be at higher risk for diabetes, hence, the selection of diabetes as a variable for analysis (Jose et al, 2014;Nguyen et al, 2015). High blood pressure, or hypertension, was selected because both hypertension and diabetes are risk factors for heart disease, identified as the cause behind the highest mortality rates among certain subethnic groups of Asian American men (Hastings et al, 2015;Ye, Rust, Baltrus, & Daniels, 2009).…”

“…California is also home to one of the highest percentages of Asian American men (U.S. Census Bureau, 2014). Asian American men, in particular, have been identified to be at higher risk for heart disease and diabetes than women (Jose et al, 2014;Nguyen, Nguyen, Fischer, Ha, & Tran, 2015). Furthermore, heart disease leads mortality rates among Japanese, Filipino, and Asian Indian men (Hastings et al, 2015).…”

Comparison of body mass index, waist circumference, and waist to height ratio in the prediction of hypertension and diabetes mellitus: Filipino-American women cardiovascular study

“…The prevalence of HTN and DM varies greatly among Asians subgroups making it necessary to study Asian ethnic groups separately for development of successful prevention, screening and treatment strategies (Holland et al, 2011). Filipino-Americans, the second largest growing Asian-American subgroup, suffer disproportionately from metabolic and cardiovascular disorders with high rates of HTN (Zhao et al, 2015, Ursua et al, 2014), DM (Wang et al, 2011, Nguyen et al, 2015, Huang and Zheng, 2015) and metabolic syndrome (Palaniappan et al, 2011, Ancheta et al, 2012). For example, in a cross-sectional study of 208,985 patients, Filipino-Americans had higher rates of HTN and difficulty attaining adequate HTN control compared to others (Zhao et al, 2015).…”

Errors Associated with Aggregating Asian American Ethnic Groups in Diabetes Research, Education, and Clinical Practice

“…In fact, most of the information regarding prevalence of T2DM among Asian Americans is aggregated across Asian American ethnic groups [1].Consequently, specific information about the incidence and prevalence of T2DM among the Asian Americans remains scanty [2].…”

“…According to Nguyen et al [1], the disaggregated data of Asian Americans showed that prevalence of diabetes was highest for Filipino, Japanese, and South Asian ethnic groups. They also pointed out that aggregating data on Asian American ethnic groups can mask the risk of T2DM for those at high risk, while inflating the risk for those at low risk [1].…”