Diabetes
Among Asian and Pacific Islander Americans
Diabetes is one of the leading causes of death and disability in the
United States, costing more than $98 billion each year.
It is a serious chronic disease in which
the body does not produce or properly use insulin. Insulin is a hormone
that is needed to convert sugar, starches, and other food into energy
needed for daily life. People who have diabetes have high levels of
glucose (sugar) in their blood. It was the seventh leading cause of
death listed on U.S. death certificates in 1995. It is the fifth
leading cause of death in Asian Americans and Pacific Islanders between
the ages of 45 and 64.
Diabetes is associated with long-term complications that may affect a
person's quality of life. It is the leading
cause of adult blindness, end-stage kidney disease, and amputations of
the foot or leg due to nerve disease. People with diabetes
are 2 to 4 times more likely to have heart disease and stroke than
people without diabetes and about two-thirds die of cardiovascular
disease.
HOW MANY ASIAN AND PACIFIC ISLANDER AMERICANS HAVE DIABETES?
Although data on the number of Asian and Pacific Islander Americans who
have diabetes are limited, studies show that type 2 diabetes is a
growing problem among some groups within this population. For example,
the prevalence of type 2 diabetes is 2 to 3 times higher among
Japanese Americans living in Seattle compared with non-Hispanic
whites. The prevalence is 2.5 times higher among Native Hawaiians
compared to white residents of Hawaii.
WHAT ARE THE DIFFERENT TYPES OF DIABETES?
Type 1 diabetes, which used to be called juvenile diabetes,
results when the body's immune system attacks and destroys its own
insulin-producing beta cells in the pancreas. People with type 1
diabetes need daily injections of insulin to live. A small number of
Asian and Pacific Islander Americans have type 1 diabetes.
Type 2 diabetes, which used to be called adult-onset diabetes,
occurs when the body doesn't makes enough insulin or cannot use the
insulin it makes effectively. This form of diabetes usually develops in
adults over the age of 40 but is becoming more prevalent in younger age
groups. Most Asian Americans and Pacific Islanders with diabetes have
type 2 diabetes.
Gestational diabetes develops or is discovered during pregnancy.
This type usually disappears when the pregnancy is over, but women who
have had gestational diabetes have a greater risk of developing type 2
diabetes later in their lives.
WHAT ARE THE SYMPTOMS OF DIABETES?
Symptoms of type 1 diabetes usually develop over a short period
of time. They include increased thirst and urination, constant hunger,
weight loss, blurred vision, and extreme fatigue. If type 1 diabetes is
not diagnosed and treated, a person can lapse into a life-threatening
coma.
The symptoms of type 2 diabetes develop gradually and are not as
noticeable as in type 1 diabetes. Symptoms include feeling tired or ill,
unusual thirst, frequent urination especially at night, weight loss,
blurred vision, frequent infections, and slow-healing wounds.
HOW IS DIABETES DIAGNOSED?
Diabetes is diagnosed by a simple lab test of a person's blood sugar
levels after they have not eaten for eight hours. A person has diabetes
if the fasting plasma glucose is 126mg/dL or greater.
WHAT FACTORS INCREASE THE CHANCES THAT ASIAN AMERICANS AND PACIFIC
ISLANDERS WILL DEVELOP TYPE 2 DIABETES?
People whose family members have diabetes are at increased risk for the
disease. Also, people who are obese, who eat a high fat diet, and who
are physically inactive are more likely to develop type 2 diabetes.
Contrary to what many people believe, diabetes is not caused by eating
too many sweets or sugary foods.
The food choices of some Asian Americans and Pacific Islanders have
changed due to their migration to the United States and to modern times.
Instead of their traditional plant- and fish-based diets, they are
choosing foods with more animal protein, animal fats, and processed
carbohydrates. In addition, they have become less physically active. As
a result, their chances of developing diabetes have increased.
CAN TYPE 2 DIABETES BE PREVENTED?
Yes. The Diabetes Prevention
Program, a research study sponsored by the National Institutes of
Health, showed that by increasing their physical activity, eating a
healthier diet, and losing between 10 and 15 pounds, 58 percent of
participants at high risk for diabetes were able to prevent the onset of
the disease.
HOW DO PEOPLE MANAGE DIABETES?
Diabetes is a self-managed disease. People with diabetes must take
responsibility for their day-to-day care by trying to keep their blood
sugar near normal levels.
People with type 1 diabetes need daily injections of insulin
because their bodies no longer produce it. Treatment requires a strict
regimen that usually includes a carefully planned diet, a physical
activity program, self-testing of blood sugar levels, and insulin
injections several times per day.
Treatment for people with type 2 diabetes typically includes
following a diet plan, getting regular physical activity, self-testing
of blood sugar levels, and in many cases, oral medication and/or insulin
injections. About 40 percent of people with type 2 diabetes require
insulin injections.
Major research studies have shown that people who keep their blood sugar
levels in the normal range can significantly delay the onset and the
progression of eye disease, kidney disease, and nerve disease. In fact,
research shows that any sustained lowering of blood sugar levels
helps prevent these diabetes complications.
The best way to measure blood glucose control is the A1C (pronounced
A-one-C) test, a simple lab test that measures the average level of
glucose in the blood over the last three months. In addition, since
people with diabetes are at an increased risk for heart disease and
stroke, they also must control their blood pressure and cholesterol. The
NDEP recommends the following targets for reducing risk of heart disease
and stroke for people with diabetes:
Blood Sugar (A1C test) ???. < 7 percent
Blood pressure???????.< 130/80 mmHg
Cholesterol (LDL)????...? < 100 mg/dl)
________________
*Adapted from Diabetes Overview and Diabetes in Asian and Pacific
Islander Americans, National Institute of Diabetes and Digestive and
Kidney Diseases, National Institutes of Health.
SOURCE: National
Diabetes Education Program
