Wide diversity within the Asian Pacific Islander American population may effect diabetes care, new research suggests. In a report published in the journal Diabetes Care, scientists discuss the need for greater understanding of the pathophysiology and prevalence of diabetes within this fast growing population.
George L. King, from the Joslin Diabetes Center and faculty member of Harvard Medical School, in collaboration with other health scientists, wrote a collaborative paper detailing the effect of diabetes on the Asian - Pacific Islander American community. Their comprehensive report provides useful insight into diabetes treatment for members of this minority group.
Type 2 Diabetes and the Asian-Pacific Islander American Community
King and his colleagues noted that type 2 diabetes is prevalent among Asian Americans, but standards used to measure the disease is confounded in this community. In most populations, type 2 diabetes is associated with obesity, but Asian American type 2 diabetes tends to affect people who have normal body weight (mean BMI 24 kg/m2 compared to 27 to 28.5 kg/m2 for other groups).
They also pointed to the 2004 New York City Health and Nutrition Examination Survey which revealed that many cases of type 2 diabetes with the Asian American community goes undiagnosed. In fact, according to their estimates, 12.1% of blacks and 11.4% of Asian American New Yorkers have diabetes but may not even know it.
Moreover, results of a study which included data obtained from the National Health Interview Study (NHIS) from 2006 through 2008, shows that when taking BMI, age and gender differences into account, Asian Americans are 70% more likely to have diabetes than to whites.
The paper also revealed that type 2 diabetes is a serious problem for Native Hawaiians. When adjusting for age, the death rate per 100,000 is 38.8 for Native Hawaiians versus 12.5 in whites and 16.3 in the State of Hawaii's general population.
Interestingly, Native Hawaiian diabetes is linked to obesity. According to the report, the prevalence of obesity and overweight is 81.5% among Native Hawaiians compared to 56.6% nationally.
Scientists speculate that discrimination against Native Hawaiians, which results in increased amounts of circulating cortisol, may account for the increased obesity within this group. Nonetheless, the fact that obesity is associated with type 2 diabetes in Native Hawaiians whereas many Asian American type 2 diabetics have normal BMI further shows the diversity and uniqueness of the Asian American-Pacific Islander American population.
Diabetes Prevalence Among Asian-Pacific Islander American Youth
Results from a study which focused on youth diabetes, revealed that diabetes is becoming a serious problem for younger Asian Americans. Data from the SEARCH for Diabetes in Youth Study which included 150 Asian Americans, 34 Pacific Islanders and 61 mixed Asian Pacific Islanders revealed that type 1 diabetes is prevalent among these groups.
But the SEARCH data also showed that type 2 diabetes is also on the rise, largely due to obesity becoming more commonplace among Asian-Pacific Islander American youth.
Going Beyond the Barrier to Treat Diabetes in Asian-Pacific Islander Americans
King and his colleagues recognized the unique challenges facing health care professionals treating diabetes in the Asian-Pacific Islander Americans. Because Asian-Pacific Islander Americans encompass such a large and diverse number of ethnic groups, barriers in language and cultural and limited resources make it difficult to treat diabetes within this population of minorities.
They pointed to the Asian American Diabetes Initiative (AADI) which is the Joslin Diabetes Center's effort to help Asian Americans become better informed about the pathogenesis of the diabetes epidemic. The AADI created a bilingual diabetes guidebook which is useful for Chinese American diabetes patients. But the authors write that greater accessibility to educational materials is necessary for the diabetic care of all Asian American groups.
Knowing that Asian-Pacific Islander Americans are great risk for developing diabetes King and his colleagues concluded that: "New support is needed to understand the needs of various diverse populations of AANHPIs on the prevention and treatment of diabetes because the significant differences in genetics, physiology, and culture among the AANHPIs have a major impact on the course of diabetes."
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King, G., McNeely, M., Thorpe, L., Mau, M., Ko, J., Liu, L., Sun, A., Hsu, W., & Chow, E. (2012). Understanding and Addressing Unique Needs of Diabetes in Asian Americans, Native Hawaiians, and Pacific Islanders Diabetes Care, 35 (5), 1181-1188 DOI: 10.2337/dc12-0210
"Asian Americans With Diabetes Face Unique Challenges" copyright 2012 Living Fit, Healthy and Happy(SM). All Rights Reserved.