Pathophysiologic Differences Among Asians, Native Hawaiians, and Other Pacific Islanders and Treatment Implications

Asian American Diabetes Initiative, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA.
Diabetes care (Impact Factor: 8.42). 05/2012; 35(5):1189-98. DOI: 10.2337/dc12-0212
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    • "sumption of processed meats and fish, and preserved condiments should be discouraged as these foods can further elevate BP (Hsu et al., 2012). Consumption of brown rice instead of white rice, soy protein or soy isoflavones, fatty fish such as mackerel and salmon, and black and green teas should be reinforced (Palaniappan et al., 2011). "
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    • "Diabetes mellitus affects about 10% of Asian Americans, with the majority having type 2 diabetes (King et al., 2012). The prevalence of this chronic disease is much greater among Asian Americans, despite the group's lower mean BMI compared to Caucasian Americans (Hsu et al., 2012). Asian Americans have a higher rate of diabetes than Whites, Blacks, and Hispanics who are in the same BMI category (Thorpe et al., 2009), and are at least 60% more likely to develop type 2 diabetes than White Americans (McNeely & Boyko, 2004). "
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    ABSTRACT: Diabetes has become a global pandemic and Chinese Americans are at least 60% more likely to develop type 2 diabetes than White Americans, despite having lower body weight, due to a combination of genetic and environmental factors. Because of the increased risk, it is vitally important to address the issues of treatment adherence and diabetes self-management in the Chinese American population. Many factors affect an individual's ability to manage diabetes, including cultural beliefs, immigration experience, language abilities/health literacy, educational background, employment, and accessibility of healthcare services. In treating Chinese American patients, these factors must be considered to determine appropriate treatment. Eastern cultural and individual beliefs differ greatly from Western beliefs and, therefore, may affect the presentation of the patients. If left unacknowledged, these differences might be misinterpreted by healthcare providers as merely treatment non-adherence or unwillingness to change. Suggestions for providing culturally competent healthcare are discussed.
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