High Diabetes Risk in New York's South Asians

July 11, 2011

By Eric Schultz

NEW YORK (Reuters Health) Jul 08 - A new study from New York City finds that immigrants from the Indian subcontinent have the highest rates of diabetes in the city -- a fact that may be masked if they're grouped with other Asians in assessments of community health risks, researchers say.

Using data from the New York City Department of Health and Mental Hygiene, the authors found that foreign-born South Asians -- including people from India, Pakistan, Bangladesh, Sri Lanka, Nepal and Bhutan -- have the highest rate of diabetes of any ethnic group in New York. Their rate is nearly double that of other foreign-born Asians.

The differences between the city's ethnic groups in diabetes rates were greatest among people with a normal body mass index (BMI), suggesting that standard BMI categories may be poor indicators of risk, at least for South Asians, the authors said in a June 29th online paper in Diabetes Care.

People of South Asian descent should be aware of these differences, and watch their weight especially carefully, said study author Leena Gupta of the city's health department. She added, "It is important for South Asians to be screened for diabetes, regardless of their body weight."

Gupta and colleagues looked at data for more than 54,000 participants in the annual New York City Community Health Survey between 2002 and 2008. Overall, 9% of people surveyed said they had been diagnosed with diabetes by a doctor. The condition was generally more common in foreign-born New Yorkers.

Among South Asians, 13.6% had diabetes -- compared with 7.4% of "other Asians" and 5.6% of U.S.-born non-Hispanic whites. The rate of diabetes was 14.4% in U.S.-born Hispanics and 11.8% in U.S.-born non-Hispanic blacks.

When the researchers stratified people according to BMI, foreign-born South Asians had the highest diabetes rates in most strata.

Among people with a normal BMI (18.5 to 25 kg/m2), the rate of diabetes in foreign-born South Asians was nearly five times the rate in whites, and two and a half times the rate in people from other parts of Asia. South Asians also had the highest rate of diabetes among overweight New Yorkers. U.S.-born Hispanics had the highest diabetes rate in the obese group, but South Asians were a very close second.

Moreover, when the authors adopted World Health Organization BMI categories tailored for specific regions and races to define who was overweight and obese, foreign-born South Asians had a higher rate of diabetes at lower BMI levels than all other racial and ethnic groups.

This means that standard BMI cutoffs typically used in the U.S. and Europe do not accurately capture the health risks of being overweight or obese for South Asians, the authors say.

Dr. Lartha Palaniappan, an associate investigator at the Palo Alto Medical Foundation in California, who was not involved in the study, said the findings highlight the importance of understanding the health differences between different Asian sub-populations.

Future studies and clinical guidelines should account for the differences between different ethnic subgroups, and not group all Asian people into one large category, she told Reuters Health.

"This study underlines the importance of using Asian-specific BMI for diabetes risk assessment," as suggested by the World Health Organization, said Dr. Grishma Parikh, an endocrinologist at the Mount Sinai Medical Center in New York.

SOURCE: http://bit.ly/oAf1aG

Diabetes Care 2011.