Asian-Americans don't have to be heavy to develop diabetes

Body mass index charts may not be relevant for assessing actual risk in this racial group.

By Victoria Stagg Elliott, AMNews staff. Feb. 23, 2004.

When the lower average body mass index of Asian-Americans is taken into account, this group has a 60% higher risk of developing type 2 diabetes than do Caucasians, according to a study published in the January Diabetes Care.

The study found that both races have similar rates of prevalence but that Asian-Americans seemed to develop the disease at lower weights.

"You don't have to be as heavy to be at the same risk," said Marguerite J. McNeely, MD, MPH, lead author and assistant professor of medicine at the University of Washington, Seattle.

Experts widely praised the study for turning the diabetes spotlight on a group that has long been thought of as having a higher risk for the disease. That risk, however, has been hard to quantify because of Asian-Americans' smaller average body mass index in comparison with Latinos or African-Americans.

"More of these studies need to be done," said William Hsu, MD, co-director of the Asian-American Diabetes Initiative at the Joslin Diabetes Center in Boston. "The Asian population living in the United States has grown very fast, and it is an important public health issue."

Many prevalence studies put Asians in the "other" category, and Latinos and African-Americans tend to be targets of minority diabetes prevention efforts because their significantly higher risk has long been documented. Dr. McNeely's study found that Asian-Americans' risk was not as high as these minorities but was still higher than Caucasians. In response, some suggest that Asian-Americans should be targeted for diabetes interventions as well and that physicians should screen for the disease in this group at lower weights and at younger ages than they would for other populations.