Elevated rates of diabetes in Pacific Islanders and Asian subgroups: The Diabetes Study of Northern California (DISTANCE)

Division of Research, Kaiser Permanente Northern California, Oakland, California.
Diabetes care (Impact Factor: 8.42). 10/2012; 36(3). DOI: 10.2337/dc12-0722
Source: PubMed


We estimated the prevalence and incidence of diabetes among specific subgroups of Asians and Pacific Islanders (APIs) in a multiethnic U.S. population with uniform access to care.RESEARCH DESIGN AND METHODS
This prospective cohort analysis included 2,123,548 adult members of Kaiser Permanente Northern California, including 1,704,363 with known race/ethnicity (white, 56.9%; Latino, 14.9%; African American, 8.0%; Filipino, 4.9%; Chinese, 4.0%; multiracial, 2.8%; Japanese, 0.9%; Native American, 0.6%; Pacific Islander, 0.5%; South Asian, 0.4%; and Southeast Asian, Korean, and Vietnamese, 0.1% each). We calculated age-standardized (to the 2010 U.S. population) and sex-adjusted diabetes prevalence at baseline and incidence (during the 2010 calendar year). Poisson models were used to estimate relative risks (RRs).RESULTSThere were 210,632 subjects with prevalent diabetes as of 1 January 2010 and 15,357 incident cases of diabetes identified during 2010. The crude diabetes prevalence was 9.9% and the incidence was 8.0 cases per 1,000 person-years and, after standardizing by age and sex to the 2010 U.S. Census, 8.9% and 7.7 cases per 1,000 person-years. There was considerable variation among the seven largest API subgroups. Pacific Islanders, South Asians, and Filipinos had the highest prevalence (18.3, 15.9, and 16.1%, respectively) and the highest incidence (19.9, 17.2, and 14.7 cases per 1,000 person-years, respectively) of diabetes among all racial/ethnic groups, including minorities traditionally considered high risk (e.g., African Americans, Latinos, and Native Americans).CONCLUSIONS
High rates of diabetes among Pacific Islanders, South Asians, and Filipinos are obscured by much lower rates among the large population of Chinese and several smaller Asian subgroups.

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Available from: Howard H Moffet, Mar 13, 2014
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    • "Increased access to foods and rapidly changing lifestyles has made type 2 diabetes a growing concern for many Asian Americans, with prevalence rates increasing from 4.7% to 7.3% between 1997 and 2008 as compared to 3.8-5.6% for Whites (Centers for Disease Control and Prevention, 2011; Karter et al., 2013; Lee, Brancati, & Yeh, 2011). There is strong evidence that early detection and management of risk factors can significantly reduce the incident of type 2 diabetes (Diabetes Prevention Program Research et al., 2009; Knowler et al., 2002). "

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    • "Chinese Americans demonstrate diabetes health disparities and face multiple challenges to diabetes management. Asians overall have a 60% to 70% greater prevalence, and although rates vary by ethnicity (e.g., South Asian versus Chinese), all groups display rates that are greater than those of Whites (Karter et al., 2013). Aspects of U.S. diabetes care that challenge Chinese American immigrants include care focused on control of the disease versus balance, and care delivered in a framework of individual versus family care (Chesla, Chun, & Kwan, 2009; Tseng, Halperin, Ritholz, & Hsu, 2013). "
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