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NO SUGAR-COATING IT: The prevalence of undiagnosed diabetes in Asian Americans is startlingly high

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I remember as a child seeing my grandfather administer shots of insulin for his diabetes. Being squeamish with needles, I didn’t enjoy watching him go through that every day. As an adult and the only physician in my family, my uncle frequently asks my opinion on how to manage his diabetes. He tells me of his last hemoglobin A1c level (a measure of his diabetes), and his strategies for managing it.

Both my grandfather and my uncle did not suffer from obesity, which is a well-known risk factor for developing diabetes. They didn’t even eat a particularly “unhealthy” diet. In fact, the research shows that Asian Americans tend to develop diabetes even without being overweight. That’s because physiologically, we tend to develop more “visceral fat” which is the fat in your gut. The “visceral fat” increases the risk of developing diabetes. Asian Americans tend to develop visceral fat at lower body mass indexes compared to their Caucasian counterparts. The point is that it’s easy to go unnoticed and undiagnosed.

Half of Asian Americans with diabetes don’t know they have it.

Did you know that half of Asian Americans who have diabetes don’t know they have diabetes? An article published in the Journal of the American Medical Association showed that among all ethnic and racial groups they studied, Asian Americans had the highest rate of diabetes that was undiagnosed. The prevalence of diabetes in the Asian American community was 21%, which is second place for the highest prevalence in any ethnic or racial group. Where do we go from here?

Get tested.

Given that diabetes is underdiagnosed in the Asian American community, please talk to your doctor about getting tested. A study by Elizabeth L. Tung, M.D., of the University of Chicago Medical Center and colleagues showed that Asian Americans had 38% lower odds of screening for diabetes than Caucasians. We need to change that in our community. Even “skinny” Asian Americans are at risk. The American Diabetes Association (ADA) recommends screening if:

• You are 45 or older and have a body mass index (BMI) greater than or equal to 23

• You are younger than 45 and have a BMI greater than or equal to 23, with one or more additional risk factors for Type 2 diabetes — such as a sedentary lifestyle or a family history of diabetes

Start practicing a lifestyle of prevention.

Although there are risk factors that we cannot control, there are two that we can control—diet and exercise. Studies show that diet and exercise can prevent your risk of developing diabetes. The research on the Diabetes Prevention Program, a structured lifestyle modification program, demonstrated that people with prediabetes who participated in the program reduced their risk of developing diabetes by 58%. Healthier eating and exercise (150 minutes of physical activity per week), helped participants lose 5-7% of their body weight. Commit to getting tested if you meet the criteria. Go online, measure your BMI, and commit to living a healthier lifestyle. —Jason Ahn, MD MPA

When you manage your diabetes, life can be sweet.

Diabetes is common in Asian-Americans, yet more than half of Asian-Americans with diabetes are undiagnosed. It’s a serious health problem that can lead to heart, kidney,nerve, and eye disease.

You can prevent or delay type 2 diabetes by staying at a healthy weight, eating well, and being active. At Equality Health, we’re working with primary care doctors to help you manage your diabetes.

To see if you’re at risk, contact your doctor. Or call the Equality Health Network at 1.833.CARE.100 (1.833.227.3100).

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