En español | Of the almost 30 million adults in the United States who have type 2 diabetes, it's no secret that African Americans are more likely to be affected: almost twice as much as Caucasians by middle age.
What's been less clear? The prevalence of diabetes and prediabetes among Hispanics and Asian Americans. New findings covering five years of health data from the Centers for Disease Control and Prevention (CDC), published in the Journal of the American Medical Association (JAMA), now show that 22 percent of Hispanics and 19 percent of Asians in the U.S. have diabetes, compared with 20 percent of blacks and 12 percent of whites.
"These are the first national estimates that include Hispanic and non-Hispanic Asian subgroups,” says study coauthor Sharon Saydah, senior scientist in the Division of Diabetes Translation at the CDC.
The study not only suggests that Hispanics have surpassed African Americans as the ethnic group with the highest rates of diabetes, it also offers a more nuanced picture of who specifically is at greatest risk within these communities. It turns out that not all Hispanics are at equal risk for developing type 2 diabetes; nor are all Asians. “There is considerable variation among the subgroups,” Saydah says.
Among Hispanics, those of Mexican and Puerto Rican descent face the highest risk, compared with those from Central or South American backgrounds. For example, 25 percent of Mexican American adults have diabetes, more than double the number of all those of South American descent with the disease.
Among Asian Americans, 23 percent of those from India, Pakistan and other South Asian countries have diabetes, while only 14 percent of those of Chinese, Japanese and Korean descent do. The study does not explain the reasons for such differences among ethnic groups, although some experts suspect that cultural traditions affecting obesity may play a role.
The hope is that these findings will help health care providers tailor their prevention and treatment strategies to better meet the needs of individual communities within these growing populations. (Collectively, Hispanics and Asians account for 23 percent of the overall population in the U.S.; that number is expected to jump to 38 percent by 2060, according to the U.S. Census Bureau.)
Take weight, for example. Health care providers will typically look at your body mass index (BMI) to determine whether you're overweight or obese. For most people, that means a BMI of 25 or greater.
But for Asian Americans, who may be at risk for diabetes even at a normal weight, a BMI of 23 or greater is considered overweight. The study also showed that Hispanics have a higher prevalence of undiagnosed diabetes, suggesting a potential lack of awareness about obesity and other risk factors.
"Type 2 diabetes is one of the growing epidemics we have in this country — the other ones being obesity, heart disease, hypertension and high cholesterol,” says Emily Nosova, M.D., a fellow in endocrinology at the Icahn School of Medicine at Mount Sinai in New York City.
"That's something we need to be mindful of in the minority community because a lot of it is hereditary. As a medical and scientific community, we haven't quite pinpointed what those inherited traits are. But the fact there are so many relatives that have these conditions speaks to the fact that there is something familial underpinning this,” Nosova adds.
If you fall within one of the particularly high-risk subgroups, “talk to your primary care doctor or your specialist about being tested at an earlier age,” she suggests. “Have a frank discussion with your health care specialist about your family history, diet and physical activity habits. Those three things are most important in your overall risk for type 2 diabetes.”
Beyond having a family history of diabetes, being overweight or being physically active less than three times a week, other important risk factors include being older than 45 or having a history of gestational diabetes (diabetes during pregnancy).
Whatever your ethnic background, don't feel you're “doomed to get diabetes,” Nosova says. Research shows that a weight loss of even 5 to 7 percent in overweight people with prediabetes reduces the risk of progressing to type 2 diabetes by as much as 58 percent.