Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 22;22(1):1954.
doi: 10.1186/s12889-022-14362-8.

Prevalence of prediabetes and diabetes vary by ethnicity among U.S. Asian adults at healthy weight, overweight, and obesity ranges: an electronic health record study

William S Vicks  1 , Joan C Lo  2   3 , Lynn Guo  4 , Jamal S Rana  2   3   5 , Sherry Zhang  1 , Nirmala D Ramalingam  6 , Nancy P Gordon  7   8
Affiliations

Prevalence of prediabetes and diabetes vary by ethnicity among U.S. Asian adults at healthy weight, overweight, and obesity ranges: an electronic health record study

William S Vicks et al. BMC Public Health. .

Abstract

Background: Asian adults develop Type 2 diabetes at a lower body mass index (BMI) compared to other racial/ethnic groups. We examined the variation in prevalence of prediabetes and diabetes among Asian ethnic groups within weight strata by comparing middle-aged Chinese, Filipino, South Asian, and White adults receiving care in the same integrated healthcare delivery system.

Methods: Our retrospective cross-sectional U.S. study examined data from 283,110 (non-Hispanic) White, 33,263 Chinese, 38,766 Filipino, and 17,959 South Asian adults aged 45-64 years who were members of a Northern California health plan in 2016 and had measured height and weight. Prediabetes and diabetes were classified based on laboratory data, clinical diagnoses, or diabetes pharmacotherapy. Age-standardized prevalence of prediabetes and diabetes were compared by race/ethnicity within healthy weight, overweight, and obesity categories, using standard BMI thresholds for White adults (18.5 to < 25, 25 to < 30, ≥ 30 kg/m2) and lower BMI thresholds for Asian adults (18.5 to < 23, 23 to < 27.5, ≥ 27.5 kg/m2). Prevalence ratios (PRs) were used to compare the prevalence of diabetes and prediabetes for Asian groups to White adults in each weight category, adjusted for age and BMI.

Results: Across all weight categories, diabetes prevalence was higher for Asian than White adults, and among Asian groups it was highest for Filipino and South Asian adults. Compared to White, PRs for South Asian men/women at healthy BMI were 1.8/2.8 for prediabetes and 5.9/8.0 for diabetes, respectively. The PRs for Filipino men/women at healthy BMI were 1.8/2.6 for prediabetes and 5.0/7.5 for diabetes, respectively. For Chinese men/women at healthy BMI, the PRs for prediabetes (2.1/2.9) were similar to Filipino and South Asian, but the PRs for diabetes were lower (2.1/3.4).

Conclusion: Chinese, Filipino, and South Asian adults have higher prevalence of prediabetes and diabetes than White adults in all weight categories, despite using lower BMI thresholds for weight classification in Asian groups. Within Asian ethnic groups, Filipino and South Asian adults had considerably higher diabetes prevalence than Chinese adults. Our data emphasize the disproportionate metabolic risk among middle-aged Asian adults and underscore the need for diabetes screening among high-risk Asian groups at healthy BMI levels.

Keywords: Asian; Chinese; Diabetes; Filipino; Obesity; Prediabetes; South Asian; Weight.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Age-standardized prevalence of diabetes and prediabetes by race/ethnicity and weight category in men and women
Fig. 2
Fig. 2
Adjusted prevalence ratio of prediabetes among non-diabetic adults aged 45–64 years
Fig. 3
Fig. 3
Adjusted prevalence ratio of diabetes among adults aged 45–64 years
Fig. 4
Fig. 4
Adjusted prevalence ratio of prediabetes among non-diabetic Asian adults aged 45–64 years
Fig. 5
Fig. 5
Adjusted prevalence ratio of diabetes among Asian adults aged 45–64 years
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Lin J, Thompson TJ, Cheng YJ, et al. Projection of the future diabetes burden in the United States through 2060. Popul Health Metr. 2018;16(1):9. doi: 10.1186/s12963-018-0166-4. - DOI - PMC - PubMed
    1. Preston SH, Choi D, Elo IT, Stokes A. Effect of Diabetes on Life Expectancy in the United States by Race and Ethnicity. Biodemography Soc Biol. 2018;64(2):139–151. doi: 10.1080/19485565.2018.1542291. - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention. Diabetes 2019 Report Card. US Department of Health and Human Services, Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/prevention/aboutprediabetes.html Accessed 5 May 2022.
    1. National Diabetes Statistics Report. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/data/statistics-report/index.html Accessed 5 May 2022.
    1. Nathan DM, Davidson MB, DeFronzo RA, et al. Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care. 2007;30(3):753–759. doi: 10.2337/dc07-9920. - DOI - PubMed

Publication types