DIABETES IN THE ASIAN AMERICAN POPULATION
Presented by Janice S. Wong R.N CDE -2007
an RN/CDE, I have worked as a staff nurse, a charge nurse,
a supervisor, a assistant manager, and a manger, working
on Med Surgical Units and in a Mental Health Unit.
have been a R.N for over 42 years and am a Certified
Diabetes Educator at Washington Hospital/Nursing Education in Fremont CA, and this has been the most rewarding
in my long career, as I am also a diabetic and have
been one for over 34 years. I have seen the spread of
Diabetes in the Asian American community , and see the
need for education for all of us, on how to live with
is a chronic disease
that is unfortunately growing very rapidly in the Asian American
population. Why you ask? Well it has many reasons….but
it has mainly to do with diet and exercise…although
genetics plays a big part in making the Asian American susceptible
to diabetes. There is so far no cure, but it can be controlled.
It is a group of diseases that is characterized by raised
levels of blood glucose resulting from defects in insulin
production or insulin action, or both. Diabetes can lead to
serious complications and premature death, but people with
diabetes can take steps to control the disease and lower the
risk of complications.(3)
are three different types of diabetes
- there are more sub groups that I will not discuss since
the treatment is the same and might cause confusion. As a
result, I want highlight Diabetes Type 2 as this is the most
common to us Asian Americans.
is an auto-immune disease. It develops when the body’s immune
system destroys pancreatic beta cells. The insulin producing cells
in the pancreas, that regulates blood glucose. People with Type 1
are usually children or young adults, however it can happen at any
age. Type 1 need insulin injections to stay alive. It accounts for
5% to 10% of all diagnosed cases of diabetes. Risk factors may be
autoimmune, genetic, or environmental. There is no known way of preventing
Type 1 Diabetes.
is a stage that people go through before developing Type 2 Diabetes.
During this time your Blood Sugars may be slightly elevated , but
not High enough to be diagnosed with diabetes…If you can get
control of your blood Glucose levels during this stage, you can
delay or prevent Type 2 diabetes from ever developing.
is caused by both a genetic tendency and external factors - i.e.
an unhealthy diet…obesity (abdominal)…lack of physical
activity… women having a high birth weight baby (over 9 pounds)…Men
with waistlines greater than 40 inches…Women with waistlines
greater than 35 inches…and people who are not obese by the
standard criteria, but are obese at the abdomen..or have high levels
of visceral fat and advancing age. Belonging to Ethnic groups with
a high tendency to develop Type 2 Diabetes ...Hispanic/ Latino American…Afro-American…Native-American…and
Asian-Americans, and Pacific Islanders . Type 2 diabetes make insulin
but cannot utilize it well (insulin resistance)
develops in women during pregnancy…have a family tendency for
diabetes and because of the Hormonal changes during pregnancy may
require insulin…..and also the hormones secreted tend to make
the insulin less effective. In most cases when the pregnancy ends
so does gestational diabetes…but the mother is at risk to develop
diabetes Type 2 in the future.
Asians who develop diabetes
in the United States defy the typical profile of a diabetic and most are
not obese. Although statistics are scarce, Dr William Hsu Co-Director
of Joslin’s Asian American Diabetes Initiative,
in 2006 estimated that 10% of the Asian adult population were diabetic.
That is in comparison with 7% of the total population estimated to have
either type of diabetes according to the Centers for Disease Control and
Chinese-speaking immigrants who were surveyed . . . were
found to have less knowledge of how to manage their diabetes
. . compared with Asian American immigrants who preferred
to speak English.
for more info.
seem to suffer the same problems of obesity
without needing to gain as much weight as those in other ethnic
groups. When Asians gain weight, they often store fat mainly in
the abdomen (visceral). Like other immigrants, Asians who arrive
in America often begin eating more and getting less exercise than
they did in their native countries. Most start to gain weight and
so do their children. They also fall victim to advertising, that
junk food is good food…fast food will help feed the family
and is cheap, and oversized. High calorie American style foods are
rapidly replacing traditional foods on their tables. (3)
Studies showed that 14% of Asian children in New York are obese,
more than twice the rate among their parents. (2)
China the number of obese people has tripled since
1992 to 90 million, as Western food has become popular and prosperity
has made it possible to eat more. The World Health Organization
has warned that Asia faces a “tsunami” of Diabetes within
the coming decade, and have condemed the Chinese Government for
its slow response to their Diabetes Crisis. (2)
In Japan, the Health Message coming over the TV to their country
men is to not eat the Western Diet….cut down on the rice…park
your car…ride your bike and walk more.
Asians have replaced traditional food with processed food, and
even Asian companies are selling processed foods that are not nutritionally
different from American processed foods, high in calories, starch and
fat. The food industry has honed their products to the children, and Asian
children are also persuaded to eat these foods, and so they do…and
so do we the Asian adults, and where is this leading us (Asians) to…..weight
AADI was established in 2000 by Joslin Research Director George
L. King, M.D., and friends of Joslin Diabetes Center, in recognition
of the growing challenge of diabetes in Asian Americans. Diabetes
disproportionately affects Asian Americans who are two times more
likely to develop the disease than Caucasians.
To study diabetes
in the Asian American population and disseminate Joslin's research
findings to healthcare providers and Asian American communities.
diabetes awareness through innovative and culturally appropriate
and implement clinical treatment programs for Asian Americans.
Asian Americans, are a busy group
- hard working, some smoking, some drinking a little alcohol, but not
many of us paying attention to what we eat, when we eat, and exercise…
using the remote control is not exercise, neither is cruising the internet.
One day you noticed you have been really tired, no energy. After eating
a meal, you just have to take a nap…and thirsty always needing to
drink soda, juice, water, and like a child having to get up to use the
toilet several times during the night. Soon you notice that no matter
how much sleep you get….it is not enough…your spouse or significant
other complains about how you doze off and are no fun anymore. You
are exhibiting the classic symptoms of diabetes. Tiredness, lethargy,
thirst, increased urination, and if not corrected soon , you may have
some weight loss…and maybe a trip to the hospital because you are
dehydrated and weak.
that you have been diagnosed with diabetes,
how do you feel? Scared, upset, can’t be me, (denial) depressed…probably
some or all of these feelings. I
felt the same way when I was diagnosed with diabetes 34 years ago. I went
into denial for about 2 weeks. No one in my family had diabetes…or
so I thought.
father was from Tokyo, my mother was born in America,
of Japanese immigrants. Hard working, but like many Asians never went
to a Doctor unless we had to. So everyone was surprised that I had diabetes…no
one spoke of it, nothing to be proud of. I was an R.N so I must know a
lot….they thought….not true…but I did learn a lot from
that day on. A few years later , my younger sister became a diabetic,
next my grandmother, my mother, and now my 2 brothers. When they say you
have such a sweet family, it is the truth.