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Diabetes Prevalence and Risk Factors in Four Asian American Communities

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Abstract

Our objective was to estimate the prevalence of diabetes and pre-diabetes and the risk associated with BMI above the Asian cut-point of 23 in 4 Asian American communities. In a convenience sample of 981 Chinese, Hmong, Korean, and Vietnamese Americans in Sacramento County, California we measured hemoglobin A1c (HbAlc), height, weight, and waist circumference. Diabetes was defined as self-reported diabetes diagnosis or HbA1c ≥ 6.5 %, and pre-diabetes as HbAlc 5.7–6.4 % with no diabetes diagnosis. We computed age-standardized prevalence of diabetes, pre-diabetes, and BMI and waist circumference above standard and Asian cut-points, and developed multivariable models of the association of diabetes and pre-diabetes with BMI and waist circumference. The 4 ethnic groups differed substantially with respect to diabetes prevalence, BMI, and waist circumference. Hmong had the highest prevalence of diabetes (15.0 %, 95 % confidence interval [CI] 10.7–19.4 %). Diabetes and pre-diabetes were associated with BMI ≥ 25 (diabetes: odds ratio [OR] 3.4, 95 % CI 2.1–5.7; pre-diabetes: OR 4.0, 95 % CI 2.7–5.8) or between 23 and 25 (diabetes: OR 1.8, 95 % CI 1.0–3.1; pre-diabetes: OR 1.6, 95 % CI 1.0–2.4). When waist circumference was added to the model, BMI effects were attenuated, and waist circumference ≥40 inches (men) or ≥35 inches (women) was associated with increased risk of diabetes (OR 3.2, 95 % CI 1.6–6.2) and pre-diabetes (OR 1.7, 95 % CI 1.0–2.9). Our findings support the use of a BMI cut-point of 23 and the importance of central adiposity as a risk factor for diabetes in Asians. Diabetes risk reduction interventions for Asians are essential.

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Acknowledgments

This study was supported through U51 PS0039441 from the Centers for Disease Control and Prevention and U54CA153499 from the National Cancer Institute. However, the views in this paper are those of the authors.

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Authors and Affiliations

  1. Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of California, Davis, Administrative Support Building (ASB), 2450 48th Street, Suite #1600, Sacramento, CA, 95817, USA

    Susan L. Stewart

  2. Director of Community Engagement and Outreach, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA

    Julie Dang

  3. Division of Hematology and Oncology, Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, CA, USA

    Moon S. Chen Jr.

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  1. Susan L. Stewart
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  2. Julie Dang
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  3. Moon S. Chen Jr.
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Correspondence to Susan L. Stewart.

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Stewart, S.L., Dang, J. & Chen, M.S. Diabetes Prevalence and Risk Factors in Four Asian American Communities. J Community Health 41, 1264–1273 (2016). https://doi.org/10.1007/s10900-016-0214-6

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