Asian-Americans are at high risk for diabetes but rarely get screened

November 15, 2016

Less than half of Asian Americans who ought to be screened for type 2 diabetes actually get tested, according to a study published Nov. 15, 2016, in the Journal of General Internal Medicine. Asian Americans have a high prevalence of undiagnosed diabetes. Yet they were the racial and ethnic group least likely, by far, to undergo recommended screening.

A team of University of Chicago researchers found that only 47.1 percent of Asian Americans received appropriate screening, compared to 60.2 percent of non-Hispanic blacks, 59.2 percent of non-Hispanic whites, 58.8 percent of multiracial adults, 58.1 percent of Hispanics, 55.6 percent of American Indians or Alaskan Natives and 50.3 percent of Pacific Islanders.

"Even after accounting for education, access to healthcare and other key factors, Asian Americans had 34 percent lower odds of being screened compared to non-Hispanic whites," said the study's lead author, Elizabeth Tung, MD, clinical instructor of medicine at the University of Chicago. "This may be an important driver of undiagnosed diabetes in this group."

The researchers analyzed data from the 2012-14 Behavioral Risk Factor Surveillance System, an annual telephone survey that collects information on health risks and preventive behaviors of United States residents. Their sample included 526,000 respondents, including 9,310 Asian Americans, who met the criteria for diabetes screening.

"Asian Americans are not necessarily averse to screening tests," said Tung. The researchers examined a subgroup of Asian Americans who completed both breast and colon cancer screening, and the lower rates of diabetes screening persisted. Both breast and colon cancer screening are "logistically and technically more involved than diabetes screening," the researchers note.

The authors of the study were concerned that many Asian patients and some of their physicians may not be fully aware that - even at lower body weights - Asians are at high risk for type 2 diabetes. About 21 percent of Asian Americans have type 2 diabetes, nearly double the rate for non-Hispanic whites. Undiagnosed diabetes is almost three times higher among Asian Americans.

Recognizing this increased risk, the American Diabetes Association (ADA) revised its screening guidelines for Asian Americans last year. They formerly recommended that Asian Americans should be screened if they were at least 45 years old. Overweight adults, those with a body mass index (BMI) of 25 or more, should be screened even if they were younger than 45.

In 2015, the ADA changed their guidelines to recommend screening for Asian Americans with a BMI of 23 or higher.

"Asian Americans should confirm with their doctors that they have been screened for diabetes," Tung said. "Doctors shouldn't neglect to screen Asian Americans just because they appear to be thin."

The study has several limitations, the authors note. Asian Americans in their study had higher educational attainment and were more fluent in English than the general population, which may have reduced barriers to accessing healthcare and the extent of the disparity. Their data source covers only 42 of the 50 United States, excluding California and Texas, the states with largest Asian populations. Additionally, the data about diabetes, breast cancer and colon cancer screening was based on self-reported information by those interviewed, which was not subject to external validation.
The study was funded by the National Institutes of Health, the Agency for Healthcare Research Quality, and the Chicago Center for Diabetes Translation Research. Additional authors were Arshiya Baig, Elbert Huang, Neda Laiteerapong and Kao-Ping Chua.

University of Chicago Medical Center

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to