4 Things to Know About Type 2 Diabetes Among Asian-Americans

About 60% of patients with diabetes worldwide are Asian.

Recently, a California physician anecdotally told The Los Angeles Times that as a doctor in training, he was used to seeing patients with type 2 diabetes who were middle-aged, ate a lot of fast food, drank soda, and were sedentary. In practice, however, he was surprised by the number of Asian-Americans he saw with healthy habits who either had diabetes or were developing the condition.

Being Asian is now considered a risk factor, as this patient population is disproportionally likely to develop type 2 diabetes.

Here are 4 diabetes-related facts pharmacists should know about their Asian-American patients:

1. More than half of Asian-Americans with diabetes are undiagnosed.

At 51%, Asian-Americans have the highest percentage of undiagnosed cases of diabetes compared with their white, African-American, and Hispanic counterparts, according to study results published in JAMA.

2. Asian-Americans tend to develop diabetes at lower body mass indexes (BMIs) than other racial groups.

It’s long been known that obesity is a risk factor for developing type 2 diabetes, but Asian-Americans tend to have lower BMIs, on average.

While the overall US population’s average BMI is nearly 29, the average for Asian-Americans is under 25.

The American Diabetes Association advises Asian-Americans to get screened for diabetes if they have a BMI of 23 or higher, which is a lower threshold than the general public, a press release from the National Institutes of Health (NIH) stated.

Andy Menke, PhD, a contractor with the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases, said it would be useful to find out more data on subgroups (eg, Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese), since the Asian population is diverse.

3. The prevalence of diabetes is 60% higher among Asian-Americans than white individuals.

A study published in Diabetes Care couldn’t determine exactly why Asian-Americans face greater risk of developing diabetes, but it conjectured that it may have to do with their skeletal frame and body composition. For example, Asian-Americans may have a greater likelihood of having intra-abdominal fat deposits.

The Asian Diabetes Prevention Initiative recommends measuring waist circumference to better understand patients’ diabetes risks. Bodies that are apple-shaped may hint at increased risk for diabetes.

“Your target measurement for waist circumference should be less than or equal to 90 cm (35.5 in) for men and 80 cm (31.5 in) for women,” the initiative stated on its website.

4. Asians in urban settings may develop diabetes at a younger age than those in rural areas.

In a span of 6 years, individuals in China aged 35 to 44 years saw an 88% increase in diabetes prevalence. For those younger than 44 years in southern India, the prevalence increased from 25% to 36% between 2000 and 2006.

“Urbanization and internal rural to urban migration result in several adverse impacts; physical activity decreases, diet habits shift towards high-energy foods, and BMI and upper body adiposity increase considerably,” wrote the authors of the study, which was published in World Journal of Diabetes.

Living in an urban setting may also mean that individuals are more exposed to air pollution, which can increase the risk of insulin resistance and diabetes, according to the Asian Diabetes Prevention Initiative.