Navigation Links
Unique physiology key to diagnosing and treating diabetes in Asian populations
Date:5/8/2012

Boston May 7, 2012 As the diabetes epidemic spreads worldwide, there is growing concern for Asian American populations, who are nearly twice as likely to develop diabetes, particularly type 2 diabetes. Compounding the problem, many of the standard ways to detect diabetes fail in people of Asian descent.

"The medical profession needs to be aware of and address the unique characteristics of this population," said George L. King, M.D., Chief Scientific Officer at Joslin Diabetes Center and Professor of Medicine at Harvard Medical School (HMS). "Without this understanding, diabetes could be misdiagnosed or missed altogether."

Dr. King was lead author of nine diabetes specialists nationwide who collaboratively wrote an article published in the May 2012 edition of Diabetes Care highlighting a comprehensive range of research findings presented at an international symposium held in Honolulu in September 2011.

The authors compiled extensive data on various groups that comprise the Asian American population, encompassing immigrants from numerous East Asian countries and those born in the United States. They also studied diabetes incidence in Native Hawaiians and Pacific Islanders.

Although there are large differences in immigration patterns and lifestyle adaptations to U.S. culture among these groups, common threads and new insights are emerging. Researchers are finding significant differences in how diabetes affects the body's chemistry, how to view body weight, and why commonly used laboratory tests may not be reliable in Asian populations.

"Type 1 diabetes can be difficult to clinically differentiate from type 2 diabetes in Asians," said Dr. William C. Hsu, M.D., who with Dr. King co-directs the Asian American Diabetes Initiative at Joslin. Dr. Hsu, an Assistant Professor of Medicine at HMS, was lead author of a team of 12 experts who wrote a second article published in the same edition of Diabetes Care. These authors focused on the pathophysiology, or the disease process, of diabetes.

Type 1 diabetes is relatively rare in Asians, with incidence five to 10 times lower than in people of European descent. But diagnosing the disease is more difficult because genetic markers and blood factors generally associated with type 1 diabetes are present in only 30 percent of patients of Asian descent. In other words, simply relying on conventional tests would lead to misdiagnosis of a large percentage of Asians who have type 1 diabetes. More research is needed to learn what other biological factors in Asians patients lead to the destruction of insulin-making beta cells, resulting in type 1 diabetes. Lab tests then could be developed to detect these specific factors.

Type 2 diabetes is the most common form of diabetes in Asian Americans, with prevalence of diagnosed cases in recent years jumping from approximately 1 or 2 percent to 10 percent today, compared with 6 percent in the general population. Many others are undiagnosed or at risk, falling into the "pre-diabetes" category. In type 2 diabetes, the pancreas produces insulin but not enough, or the body's cells resist its effect. A risk factor commonly associated with type 2 diabetes is excess weight, often measured by calculating the body mass index (BMI).

But for Asian Americans with type 2 diabetes, the average BMI is between 24 and 25, well within the normal BMI range (19󈞅) for the general population.

"The BMI in Asian patients can be misleading. They can look quite skinny," Dr. Hsu said. "Instead, we're learning that a better indicator of type 2 diabetes risk in Asians is fat deposits at the waistline." More research is needed to understand how visceral fat contributes to the onset of type 2 diabetes. If detected in the pre-diabetes stage, the disease often can be prevented.

To diagnose diabetes, a commonly used toolthe fasting plasma glucosefails to detect abnormal glucose tolerance in many Asian Americans. The authors recommend the oral glucose tolerance test, which although more cumbersome to do, has greater sensitivity and reliability in Asian populations.

Per diabetes complications, physicians need be aware that Asian Americans with diabetes tend to have a lower incidence of cardiovascular disease but higher rates of end-stage renal disease. These patients need to be monitored and treated accordingly.

Per treatments for diabetes, the authors cited the need for more studies: "The unique features of diabetes pathophysiology within this very heterogeneous population may indicate a need for different treatment guidelines." Insulin dosing, oral medications and lifestyle factors such as exercise and nutrition should be enfolded into a diabetes care program tailored to individuals, families and cultural practices.

The team of experts at Joslin's Asian Diabetes Initiative has found that educational materials are most effective when published in both the Asian language and English, allowing younger and older generations to communicate fluidly. Joslin also has developed multilingual websites.

Community-based education programs, which also have proved to be highly effective, need to be expanded. And in national data collection, it is important to include Asian groups as subsets of the general population, with culturally appropriate methods incorporated into the design of surveys.

"While there is much to be gained from ethnically sensitive care, these considerations are only a starting point," Dr. Hsu said. "Ultimately, all diabetes care needs to be tailored to the individual. That's the direction that medicine is going, and all populations will benefit."


'/>"/>

Contact: Jeffrey Bright
jeffrey.bright@joslin.harvard.edu
617-309-1957
Joslin Diabetes Center
Source:Eurekalert  

Related medicine news :

1. Bariatricfurnishings.com Launches Unique Eco-friendly Seating for Health Care, Hospitality, Assisted Living Centers, and Home Use at Competitive Prices
2. Product Innovators Launch Unique Sensory Tool for Special Needs Youth
3. Beware the Gentle Man With Unique Knowledge: The Passion and Skill of a Rising Star
4. Cloud Computing Platforms Address Unique M2M Application Needs, According To New SensorLogic White Paper
5. UniqueU Medical Weight Loss Program Opens Cincinnati Location
6. Biocell Center Corporation Partners with New Englands Largest Community-Based Hospital Network to Offer a Unique Service in Amniotic Fluid Stem Cell Preservation
7. Unique Equipment, Fun Workouts, Extraordinary Results
8. China VoIP & Digital Telecom Subsidiary, Beijing PowerUnique Technologies, Wins Virtualization Project Bid for Peking Universitys Third Hospital
9. 12 Unique Iridoids Have Been Found in Noni Fruit
10. Unique Alzheimer's Program Improves Quality Of Life And Provides Purpose
11. UniqueU Medical Weight Loss Success Requires an Expansion and Move to a Larger Location
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Unique physiology key to diagnosing and treating diabetes in Asian populations
(Date:5/26/2017)... ... May 26, 2017 , ... ... CareFusion NOX-T3 portable sleep monitor with its Somnoware Sleep Device Interface (SDI). Somnoware ... for diagnostic device operations. With this platform, initializing devices and importing studies are ...
(Date:5/26/2017)... Sparks, Nevada (PRWEB) , ... May 26, 2017 ... ... to produce the first ever copper, antimicrobial, mesh back 24/7 task chair specifically ... and conference applications. “We are thrilled to partner with Cupron® to provide ...
(Date:5/26/2017)... Texas (PRWEB) , ... May 26, 2017 , ... Yisrayl ... a new publication this week that is focusing on the Peace Agreements being discussed ... his Middle East sprint in a race to try to speed up peace talks ...
(Date:5/26/2017)... Francisco, CA (PRWEB) , ... May 26, 2017 , ... ... Francisco, is proud to announce a new, informational blog post on insurance options. If ... surgery, checking insurance plans may help save time and money. Visiting an in-network provider ...
(Date:5/26/2017)... ... 26, 2017 , ... Centennial-based BluSky Restoration Contractors announced that ... Annual Clays for Kids fundraiser, to be held Friday, Sept. 22, at Kiowa ... part of BluSky’s partnership with The Adoption Exchange, BluSky will also share sponsorship ...
Breaking Medicine News(10 mins):
(Date:5/18/2017)...  Two Bayer U.S. Pharmaceutical leaders received top awards ... 28 th Woman of the Year ... longstanding mission of furthering the advancement and impact of ... Cindy Powell-Steffen , senior director of brand activation and ... Libby Howe , a regional business manager for New ...
(Date:5/15/2017)... Inc., a privately-held CNS pharmaceutical company based in ... disease (PD), has enrolled the first patient in the RASMET ... study involving patients with PD and taking place at 12 ... period. The first stage is open label and involves single ... Denver , Boca Raton ...
(Date:5/10/2017)... Inc. (Nasdaq: HOLX ) announced today the ... April 1, 2017 .   GAAP diluted earnings per ... prior year period as the sale of the blood ... diluted EPS of $0.50 increased 6.4%.  Revenue of $715.4 ... Excluding the effects of blood screening and the acquired ...
Breaking Medicine Technology: