Diabetes Prevalence High in Hawaiian/Pacific Islanders and Asians
Diabetes Prevalence High in Hawaiian/Pacific Islanders and Asians
The prevalence of diabetes among Asians, Native Hawaiians, and Pacific Islanders exceeds diabetes prevalence among whites in the United States, according to new data published online in the Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention (CDC).
The national-level findings are consistent with previous reports, but this is the first study to provide state-specific diabetes prevalence for Asians and Native Hawaiians/Pacific Islanders for those states and territory with sufficient data for analysis.
"Effective interventions and policies might reduce the prevalence of diabetes in these growing, high-risk minority populations," write Karen A Kirtland, PhD, and colleagues in the Division of Diabetes Translation at the CDC.
High rates of diabetes among these racial groups "might reflect elevated genetic susceptibility, higher prevalences of risk factors such as obesity, physical inactivity, educational attainment, or a combination of these and other factors," they add.
The authors analyzed data from the 2011 to 2014 Behavioral Risk Factor Surveillance System to determine the prevalence of diabetes and risk factors among adult Asians, Native Hawaiians, and Pacific Islanders in the US.
Cases were determined based on a "yes" response to the question, "Have you ever been told by a doctor that you have diabetes?" Risk factors assessed included age, sex, educational attainment, lack of leisure-time physical activity in the past month, and body mass index (BMI), which indicated being overweight as a BMI of 25 to 29.9 kg/m or obese as a BMI > 29.9 kg/m.
Higher Diabetes Rates Among Native Hawaiians/Pacific Islanders than Asians
After age adjustment, the prevalence of diabetes among Native Hawaiians and Pacific Islanders combined in California, Hawaii, New York, Utah, Washington, and Guam ranged from a low of 13.4% in New York to a high of 19.1% in California.
Overall diabetes prevalence in these states was 14.3% for Native Hawaiians/Pacific Islanders compared with 8% among whites (P < .001).
And age-adjusted diabetes prevalence, rates of overweight or obesity, and likelihood of educational status below high school completion were all greater for Native Hawaiians/Pacific Islanders than Asians in these states.
Full adjustment for diabetes risk factors, however, made the difference in diabetes prevalence no longer significant between Native Hawaiians/Pacific Islanders and Asians, suggesting that the risk factors of overweight/obesity and lack of high school completion might account for the differing rates of diabetes, the authors write.
Similarly, diabetes rates were 13.9% for Native Hawaiians/Pacific Islanders and 8.8% for Asians in Hawaii (P = .001 for the prevalence difference between the groups), 18.6% for Native Hawaiians/Pacific Islanders and 6.4% for Asians in Utah, and 15.7% for Native Hawaiians/Pacific Islanders and 8.5% for Asians in Guam (P < .001).
The proportions were flipped in New York, nonsignificantly, where 13.5% of Native Hawaiians/Pacific Islanders and 15.3% of Asians had diabetes (P = .647). The difference in diabetes rates between Native Hawaiians/Pacific Islanders and Asians didn't reach significance in Washington state either (17.8% vs 10%; P = .054).
Asians Had Higher Diabetes Prevalence than Whites
Based on data from 32 states, the District of Columbia, and Guam, the overall prevalence of diabetes in Asians was 9.8%, higher than the 8% in whites, and ranging from a low of 4.9% in Arizona to a high of 15.3% in New York.
The eight states with the highest quartile of diabetes prevalence among Asians (> 10.5%) included Iowa, Kentucky, Massachusetts, Nevada, New York, North Carolina, Oklahoma, and South Carolina.
"Diabetes is a major public health problem that disproportionately affects Asians and Native Hawaiians/Pacific Islanders. The state-specific data from this study could be used to create more effective interventions and policies to reverse the large diabetes burden in these growing, high-risk minority populations," say the authors.
"Continued surveillance for diabetes and its risk factors among Asians and Native Hawaiians/Pacific Islanders is an important component in monitoring progress toward reducing their burden of diabetes," they conclude.
The authors reported no external funding and no disclosures.
MMWR. 2015;64:1261-1266. Full text
The prevalence of diabetes among Asians, Native Hawaiians, and Pacific Islanders exceeds diabetes prevalence among whites in the United States, according to new data published online in the Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention (CDC).
The national-level findings are consistent with previous reports, but this is the first study to provide state-specific diabetes prevalence for Asians and Native Hawaiians/Pacific Islanders for those states and territory with sufficient data for analysis.
"Effective interventions and policies might reduce the prevalence of diabetes in these growing, high-risk minority populations," write Karen A Kirtland, PhD, and colleagues in the Division of Diabetes Translation at the CDC.
High rates of diabetes among these racial groups "might reflect elevated genetic susceptibility, higher prevalences of risk factors such as obesity, physical inactivity, educational attainment, or a combination of these and other factors," they add.
The authors analyzed data from the 2011 to 2014 Behavioral Risk Factor Surveillance System to determine the prevalence of diabetes and risk factors among adult Asians, Native Hawaiians, and Pacific Islanders in the US.
Cases were determined based on a "yes" response to the question, "Have you ever been told by a doctor that you have diabetes?" Risk factors assessed included age, sex, educational attainment, lack of leisure-time physical activity in the past month, and body mass index (BMI), which indicated being overweight as a BMI of 25 to 29.9 kg/m or obese as a BMI > 29.9 kg/m.
Higher Diabetes Rates Among Native Hawaiians/Pacific Islanders than Asians
After age adjustment, the prevalence of diabetes among Native Hawaiians and Pacific Islanders combined in California, Hawaii, New York, Utah, Washington, and Guam ranged from a low of 13.4% in New York to a high of 19.1% in California.
Overall diabetes prevalence in these states was 14.3% for Native Hawaiians/Pacific Islanders compared with 8% among whites (P < .001).
And age-adjusted diabetes prevalence, rates of overweight or obesity, and likelihood of educational status below high school completion were all greater for Native Hawaiians/Pacific Islanders than Asians in these states.
Full adjustment for diabetes risk factors, however, made the difference in diabetes prevalence no longer significant between Native Hawaiians/Pacific Islanders and Asians, suggesting that the risk factors of overweight/obesity and lack of high school completion might account for the differing rates of diabetes, the authors write.
Similarly, diabetes rates were 13.9% for Native Hawaiians/Pacific Islanders and 8.8% for Asians in Hawaii (P = .001 for the prevalence difference between the groups), 18.6% for Native Hawaiians/Pacific Islanders and 6.4% for Asians in Utah, and 15.7% for Native Hawaiians/Pacific Islanders and 8.5% for Asians in Guam (P < .001).
The proportions were flipped in New York, nonsignificantly, where 13.5% of Native Hawaiians/Pacific Islanders and 15.3% of Asians had diabetes (P = .647). The difference in diabetes rates between Native Hawaiians/Pacific Islanders and Asians didn't reach significance in Washington state either (17.8% vs 10%; P = .054).
Asians Had Higher Diabetes Prevalence than Whites
Based on data from 32 states, the District of Columbia, and Guam, the overall prevalence of diabetes in Asians was 9.8%, higher than the 8% in whites, and ranging from a low of 4.9% in Arizona to a high of 15.3% in New York.
The eight states with the highest quartile of diabetes prevalence among Asians (> 10.5%) included Iowa, Kentucky, Massachusetts, Nevada, New York, North Carolina, Oklahoma, and South Carolina.
"Diabetes is a major public health problem that disproportionately affects Asians and Native Hawaiians/Pacific Islanders. The state-specific data from this study could be used to create more effective interventions and policies to reverse the large diabetes burden in these growing, high-risk minority populations," say the authors.
"Continued surveillance for diabetes and its risk factors among Asians and Native Hawaiians/Pacific Islanders is an important component in monitoring progress toward reducing their burden of diabetes," they conclude.
The authors reported no external funding and no disclosures.
MMWR. 2015;64:1261-1266. Full text
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