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 Study and the Multi-Ethnic Study of Atherosclerosis

Division of General Internal Medicine, University of California, San Francisco, San Francisco, California 94115, USA.
Metabolic syndrome and related disorders (Impact Factor: 1.98). 11/2009; 8(2):157-64. DOI: 10.1089/met.2009.0062
Source: PubMed


Individuals from South Asia have high diabetes prevalence despite low body weight. We compared the prevalence of diabetes among South Asian Indians with other U.S. ethnic groups and explored correlates of diabetes.
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 classified by fasting plasma glucose (FPG) >or=126 mg/dL, 2-h postchallenge glucose >or=200 mg/dL, or use of hypoglycemic medication.
A total of 29% of Asian Indians had diabetes, 37% had prediabetes, and 34% had normal glucose tolerance. After full adjustment for covariates, Indians still had significantly higher odds of diabetes compared to whites and Latinos, but not significantly different from African Americans and Chinese Americans in MESA: Indians [odds ratio (OR), 1.0], whites [OR, 0.29; 95% confidence 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, microalbuminuria, carotid intima media thickness, and stronger traditional Indian beliefs.
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.

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    • "For example, first and second generation UK South Asians (people tracing ancestry to India, Pakistan, Bangladesh, or Sri Lanka are termed South Asians) have disproportionately higher rates of coronary heart disease and are more likely to die earlier from cardiovascular causes than their White European counterparts [1]. Whilst an increased prevalence of diabetes within this South Asian diaspora is a well-recognised contributory factor, this and other established risk factors appear not to entirely account for continued discrepancies in rates of cardiovascular morbidity [2] [3] [4] [5]. It is plausible that an alternative, unexplained pathophysiology drives premature arterial thromboembolic disease within this ethnic group. "
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    • "We conducted a cross-sectional study of 150 South Asian Indians recruited from the San Francisco Bay Area between August 2006 and October 2007 called the Metabolic Syndrome and Atherosclerosis in South Asians Living in America (MASALA) study. The sampling strategy and recruitment procedures have been previously described (15). Briefly, this study was modeled on the Multi-Ethnic Study of Atherosclerosis (MESA) (16). "
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