Article

Type 2 Diabetes in Asians: Prevalence, Risk Factors, and Effectiveness of Behavioral Intervention at Individual and Population Levels

Nutrition and Health Sciences Department, Division of Biological and Biomedical Sciences, Emory University, Atlanta, Georgia 30322, USA.
Annual Review of Nutrition (Impact Factor: 8.36). 04/2012; 32(1):417-39. DOI: 10.1146/annurev-nutr-071811-150630
Source: PubMed

ABSTRACT

This review summarizes the current data on diabetes risk factors, prevalence, and prevention efforts in Asia and Asian migrant populations. Studies indicate that type 2 diabetes mellitus is a large and growing threat to public health in Asian populations. Furthermore, Asian subgroups (e.g., South Asians/Asian Indians, Chinese) have unique risk factor profiles for developing diabetes, which differ from other populations and between Asian ethnic groups. Lifestyle intervention programs are effective in preventing diabetes in Asians, as with other ethnicities. The strength of these findings is lessened by the lack of systematically collected data using objective measurements. Large epidemiologic studies of diabetes prevalence and risk factor profiles and translational trials identifying sustainable and culturally acceptable lifestyle programs for Asian subgroups are needed.

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    • "The alarming increase in the prevalence of diabetes in Asia can be explained in terms of several causes. The typical ethnic background of the Asian population involves a lower body mass index (BMI) with more visceral fat, a young age of diabetes onset , and significant historical changes during the past decades; all of these factors could contribute to a high prevalence of dia- betes2345678. Another important contributor to the high prevalence of diabetes in Asia is the presence of the most populated countries, China and India. "
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    ABSTRACT: The prevalence of diabetes is increasing globally, particularly in Asia. According to the 2013 Diabetes Atlas, an estimated 366 million people are affected by diabetes worldwide; 36% of those affected live in the Western Pacific region, with a significant proportion in East Asia. The reasons for this marked increase in the prevalence of diabetes can be extrapolated from several distinct features of the Asian region. First, the two most populated countries, China and India, are located in Asia. Second, Asians have experienced extremely rapid economic growth, including rapid changes in dietary patterns, during the past decades. As a result, Asians tend to have more visceral fat within the same body mass index range compared with Westerners. In addition, increased insulin resistance relative to reduced insulin secretory function is another important feature of Asian individuals with diabetes. Young age of disease onset is also a distinctive characteristic of these patients. Moreover, changing dietary patterns, such as increased consumption of white rice and processed red meat, contributes to the deteriorated lifestyle of this region. Recent studies suggest a distinctive responsiveness to novel anti-diabetic agents in Asia; however, further research and efforts to reverse the increasing prevalence of diabetes are needed worldwide.
    Full-text · Article · Oct 2015
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    • "Type 2 Diabetes Mellitus (T2DM) is a multifactorial disease involving both genetic and environment factors [1]. Diabetes mellitus is generally classified into 4 groups based on their pathogenesis with T2DM as the most frequent group (90– 95%). "
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    ABSTRACT: Background: Type 2 Diabetes Mellitus (T2DM) is a multifactorial disease involving both genetic and also environmental factors. Potassium inwardly-rectifying channel, subfamily J, member 11 (KCNJ11) gene, an ATP-sensitive potassium channel-coding gene, contributes to insulin secretion. Objectives: This research aimed to investigate E23K polymorphism in KCNJ11 gene and insulin secretion in individuals with family history of T2DM (cases) and without family history of T2DM (controls). Method: This research was a case-control study involving 34 cases and 34 controls. E23K polymorphism of KCNJ11 was detected with PCR-RFLP. All of the obtained data were statistically analyzed with T-test, Mann-Whitney U-test, Chi-Square and One-Way ANOVA. Result: Frequency of AA genotype in individuals with family history of T2DM (41%) was higher than in individuals without family history of T2DM (6%) (p = 0.001). Frequency of A allele in individuals with family history of T2DM (68%) was higher than in individuals without family history of T2DM (38%) (p = 0.001). The risk of A allele in individuals with family history of T2DM was 3 times higher than in individuals without family history of T2DM (p = 0.001, OR 3.38, CI 95% 1.67-6.84). Homeostasis Model Assessment β (HOMA-β) values of AA genotype (85.44%. ±. 39.55) were lower than that of GA (212.20%. ±. 79.30) and GG (254.00%. ±. 61.98) genotypes (p = 0.000). Conclusion: The risk of having A allele in individuals with family history of T2DM is higher than that in individuals without family history of T2DM. HOMA-β values of AA genotype are lower than that of GA and GG genotypes.
    Full-text · Article · Jun 2015 · Egyptian Journal of Medical Human Genetics
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    • "Third, there may be population-specific genetic effects as a result of gene-gene and gene-environment interactions [67], [68]. Asians have been reported to have unique risk factor profiles for developing diabetes that differ from those in Caucasians [69]. All the above-mentioned factors might have contributed to the heterogeneous association results across ethnic groups. "
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    ABSTRACT: The evidence that the variants GCK rs1799884, GCKR rs780094, MTNR1B rs10830963 and G6PC2 rs560887, which are related to fasting plasma glucose levels, increase the risk of type 2 diabetes mellitus (T2DM) is contradictory. We therefore performed a meta-analysis to derive a more precise estimation of the association between these polymorphisms and T2DM. All the publications examining the associations of these variants with risk of T2DM were retrieved from the MEDLINE and EMBASE databases. Using the data from the retrieved articles, we computed summary estimates of the associations of the four variants with T2DM risk. We also examined the studies for heterogeneity, as well as for bias of the publications. A total of 113,025 T2DM patients and 199,997 controls from 38 articles were included in the meta-analysis. Overall, the pooled results indicated that GCK (rs1799884), GCKR (rs780094) and MTNR1B (rs10830963) were significantly associated with T2DM susceptibility (OR, 1.04; 95%CI, 1.01-1.08; OR, 1.08; 95%CI, 1.05-1.12 and OR, 1.05; 95%CI, 1.02-1.08, respectively). After stratification by ethnicity, significant associations for the GCK, MTNR1B and G6PC2 variants were detected only in Caucasians (OR, 1.09; 95%CI, 1.02-1.16; OR, 1.10; 95%CI, 1.08-1.13 and OR, 0.97; 95%CI, 0.95-0.99, respectively), but not in Asians (OR, 1.02, 95% CI 0.98-1.05; OR, 1.01; 95%CI, 0.98-1.04 and OR, 1.12; 95%CI, 0.91-1.32, respectively). Our meta-analyses demonstrated that GCKR rs780094 variant confers high cross-ethnicity risk for the development of T2DM, while significant associations between GCK, MTNR1B and G6PC2 variants and T2DM risk are limited to Caucasians.
    Full-text · Article · Jun 2013 · PLoS ONE
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