Division of General Internal Medicine, University of California, San Francisco, San Francisco, California.
University of California, San Diego, La Jolla, California.
Wake Forest University Medical Center, Winston-Salem, North Carolina.
Los Angeles BioMedical Research Institute, Torrance, California.
Stony Brook University Hospital, Stony Brook, New York.
Department of Medicine, Northwestern University, Chicago, Illinois.
Prevalence and Correlates of Diabetes in South Asian Indians
in the United States: Findings From the Metabolic Syndrome
and Atherosclerosis in South Asians Living in America and
Multi-Ethnic Study of Atherosclerosis Studies
A.M. Kanaya, M.D.,1 C.L. Wassel, Ph.D.,2 D. Mathur, M.B.B.S.,1 A. Stewart, Ph.D.,1 D. Herrington, M.D.,3
M.J. Budoff, M.D.,4 V. Ranpura, M.B.B.S.,5 and K. Liu, Ph.D.6
Background: Individuals from South Asia have high diabetes prevalence despite low body weight. We com-
pared the prevalence of diabetes among South Asian Indians with other U.S. ethnic groups and explored cor-
relates of diabetes.
Methods: This was a cross-sectional study of 150 South Asian Indians (ages 45–79) in California, using similar
methods to the Multi-Ethnic Study of Atherosclerosis (MESA). Type 2 diabetes was classifi ed by fasting plasma
glucose (FPG) ≥126 mg/dL, 2-h postchallenge glucose ≥200 mg/dL, or use of hypoglycemic medication.
Results: A total of 29% of Asian Indians had diabetes, 37% had prediabetes, and 34% had normal glucose tol-
erance. After full adjustment for covariates, Indians still had signifi cantly higher odds of diabetes compared to
whites and Latinos, but not signifi cantly different from African Americans and Chinese Americans in MESA:
Indians [odds ratio (OR), 1.0], whites [OR, 0.29; 95% confi dence interval (CI), 0.17–0.49], Latinos (OR, 0.59; CI, 0.34–
1.00) African Americans (OR, 0.77; CI 0.45–1.32), Chinese Americans (OR, 0.78, CI, 0.45–1.32). Variables associated
with prediabetes or diabetes among Indians included hypertension, fatty liver, visceral adiposity, microalbu-
minuria, carotid intima media thickness, and stronger traditional Indian beliefs.
Conclusions: Indian immigrants may be more likely to have diabetes than other U.S. ethnic groups, and cultural
factors may play a role, suggesting that this is a promising area of research.
of India leading the world with approximately 79.4 million
people with diabetes in 2030.1 Consistent with these statistics,
several studies from the South Asian diaspora have found
South Asians (individuals from India, Pakistan, Bangladesh,
Nepal, and Sri Lanka) have 2- to 4-fold increased prevalence
of type 2 diabetes compared to other ethnic groups.2–5 Only
a few studies have systematically measured diabetes preva-
lence among South Asians in the United States,6–8 but none
have used the 2-h glucose tolerance as a diagnostic test.
urrently, india has the second largest number of indi-
viduals with type 2 diabetes globally, with projections
South Asians may have increased genetic susceptibility
to diabetes,9 which is further enhanced by environmental
triggers such as physical inactivity, excessive caloric intake,
and obesity. Less attention has been paid to specifi c cultural
factors that may also increase diabetes risk.
We aimed to determine the prevalence and correlates
of type 2 diabetes and prediabetes in a population-based
sample of South Asian Indians from the San Francisco Bay
Area. We used similar sampling methods, eligibility cri-
teria, clinical and laboratory measures to the Multi-Ethnic
Study of Atherosclerosis (MESA) to effi ciently compare risk
factor associations between the South Asian Indians and
METABOLIC SYNDROME AND RELATED DISORDERS
Volume X, Number X, 2009
© Mary Ann Liebert, Inc.