The Misdiagnosis of Diabetes in Asian-Americans
Diabetes is an increasing threat for the Asian-American community. Although the majority of the Asian-American population do not suffer from diabetes-related conditions such as obesity, statistics have shown that Asian-Americans (particularly Pacific Islanders and Southeast Asians) have an 18% higher chance of developing diabetes than non-Hispanic whites. Diabetes affects roughly 10% of all Asian-Americans in the United States, and out of that percentage, 90-95% of Asian-Americans are estimated to be type 2. However, since diabetes symptoms in Asian-Americans may not be as apparent as they are in people of other ethnic backgrounds, the likelihood of misdiagnosing diabetes in Asian-Americans is high. As a result, most general statistics surrounding diabetes do not accurately account for people of this unique genetic makeup.
Many healthcare professionals may not even consider diabetes to be a diagnosis for an Asian-American person if his or her BMI scores in the healthy range (18.5-24.9). In reality, many Asian-Americans develop type 2 diabetes even with a BMI of less than 25. Similarly, while typical screenings for a person with type 1 diabetes would exhibit an autoimmune response against cells that produce insulin, tested type 1 Asian-Americans only show this result half of the time. While these odd results are predicted to stem from genetic factors, healthcare professionals still do not fully understand them and often have difficulty distinguishing between type 1 and type 2 in Asian-American patients. Furthermore, as other diabetes symptoms such as excessive urination, frequent thirst, and fatigue may suggest other medical conditions, misdiagnosis for Asian-Americans becomes all the more common.
The increasing likelihood of an Asian-American person developing diabetes proves to be a result of both genetic and environmental factors. Second and third generation Asian-Americans in the United States have become more susceptible to developing diabetes due to adopting a more fatty, Western diet, as well as engaging in a less active lifestyle. Recent research details that even small weight gain may sharply increase the odds of a type 2 diabetes diagnosis for a person of Asian-American descent. Bodily fat deposits at the waistline may be an important indicator.
Although Asian-Americans are one of the largest ethnic groups in the United States impacted by diabetes and most likely at risk for misdiagnosis, studies show that they are still less likely to die from diabetes-related causes than non-Hispanic whites. However, diabetes can still cause complications in Asian-Americans that are equally prevalent in every other ethnic group, such as eye, kidney, heart, and nerve damage. As with any diabetes patient, careful lifestyle modifications in diet, weight management, and physical activity can delay and even prevent the progression of diabetes.
1- Asian American Diabetes Initiative, Joslin Diabetes Center. Why do people of Asian descent get diabetes?, http://aadi.joslin.org/content/asian/why-are-asians-higher-risk-diabetes. (Accessed 5/14/12).
2- NYU Langone Medical Center. Diabetes Among South Asian-Americans, http://asian-health.med.nyu.edu/dream/diabetes-south-asian-communities/diabetes-among-south-asians. (Accessed 5/14/12).
3- Joslin Diabetes Center. Asian-Americans and Diabetes, http://www.joslin.org/info/Asian_Americans_and_Diabetes.html. (Accessed 5/14/12).
4- Defeat Diabetes Foundation. Asian-Americans Face Higher Diabetes Risk and Not Being Screened, http://www.defeatdiabetes.org/Articles/asianamericans050613.htm. (Accessed 5/14/12).
5- Institute for Alternative Futures. United States' Diabetes Crisis Among Asian-Americans: Today and Future Trends, http://www.altfutures.org/pubs/diabetes2025/US_Diabetes2025_AsianAmericans_BriefingPaper_2011.pdf. (PDF). (Accessed 5/14/12).
6- Daily Rx. Diabetes in Asian-Americans: Type-What?, http://www.dailyrx.com/news-article/type-1-and-type-2-diabetes-asian-americans-identified-joslin-researchers-16397.html. (Accessed 5/14/12).
Reviewed by Jason C. Baker, MD. 8/12
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